Nd-YAG laser treatment of primary and recurrent pilonidal sinus

Abstract

A pilonidal sinus usually contains hair and extensive vascularization due to inflammation, which theoretically gives Nd-YAG laser waves the potential to destroy the deep fistula systems of the sinus without affecting the overlying skin. We describe our preliminary experience with Nd-YAG laser waves in the treatment of pilonidal sinus. A total of 41 consecutive patients with pilonidal sinus underwent the intended Nd-YAG laser treatment. Structured telephone interviews were carried out in 37 patients (90%). The median duration of treatment and observation time were 5.1 months and 15.2 months, respectively. Three patients (7%) received additional surgery: two had granulomas removed via a minor excision, and one requested more traditional surgery. At follow-up, 28 out of the 37 patients (75.7%) reported freedom from symptoms without supplementary treatment, and 30 (81%) were symptom-free after supplementary laser treatment and minimal surgery, if needed. We have identified a potential treatment for pilonidal sinus that is extremely gentle compared with conventional surgery. We aim to substantially increase the cohort of patients undergoing this treatment and follow up these patients with a register-based technique with a comparable control group. The Nd-YAG laser may prove to be an attractive treatment alternative for pilonidal sinus.