Semiconductor laser treat chronic rhinitis under nasal endoscope

Since the Jako 20 Century 70's introduction of laser technology to the ENT field, many scholars have tried to various laser for the treatment of chronic rhinitis .all the many advantages of laser performance. The author in August 2002 to February 2003 under nasal endoscopy during the use of GaAlAs semiconductor laser treatment for the treatment of 32 patients with chronic rhinitis patients achieved satisfactory results.

1.materials and methods

1.1
clinical data 32 patients were 18 males and 14 females, aged 17 to 72 years, mean 39 years, persistent nasal obstruction for more than six months, up to 8 years, part of a runny nose, tinnitus, dripping with decongestants is not sensitive; who had no history of nasal and sinus surgery; sinus CT exclude sinusitis, nasal polyps, turbinate bone hypertrophy. Nasal endoscopy, bilateral in 18 cases of chronic hypertrophic rhinitis, allergic rhinitis and 8 cases, 3 cases of chronic simple rhinitis, nasal septum deviation and inferior turbinate back with varying degrees of proliferative lesions in 3 cases.

1.2
Treatment methods Nasal endoscopy (Stryker Corporation production), diameter 4 mm 0 ° endoscope angle view, TV monitoring system (Trinitron Color Video Monitor, 1998 by Sony corporation), using the GaAlAs diode laser therapy, a wavelength of 810 nm, maximum output power of 25 W, with 600μm SMA905 standard output fiber (contact), aiming beam for the 650nm red laser diode.

Patients were supine, with 1% tetracaine cotton pad into the nasal cavity three times as the mucosal surface anesthesia, hypertrophic mucosa at the back end of middle turbinate can use 1% lidocaine local anesthesia under endoscopic screening recess butterfly . Fiber laser output issued in endoscopic nasal turbinate hypertrophy and polypoid changes organizations, output power 12 ~ 15 W, laser light with continuous output mode, along the free margin of the inferior turbinate direct gasification front to back, to the organization contracted the nasal cavity to form a good airway and the back end of inferior turbinate, the exposed area after the nostril diameter not less than 5mm. Observe patients after 1 h, no bleeding, and adverse reactions. 1% ephedrine nasal cavity, 5% cortisone alternating nasal fluid, clear nasal discharge 2 times, 1 week after basically no nasal discharge, 2 weeks to recover basic .

1.3
Evaluation standard markedly: nasal patency, ventilation function well; effective: nasal ventilation significantly improved than before; invalid: no improvement in nasal congestion.

2. results
Markedly effective in 23 cases (72%), effective in 8 cases (25%), 1 patient (3%), the total effective rate 97%. 1 patient Department of the side of the nasal septum and inferior nasal a part of the phase of bone paste, postoperative ventilation without improvement.

3.discussion
In clinical work, but not for chronic rhinitis and sinusitis patients, often with conventional
surgery, electrocautery, microwave, freezer and other treatment. Drawback is that easy to intraoperative and postoperative bleeding, local tissue reactions after re-take repeated dressing changes 2 to 3 weeks.
Semiconductor laser is just the last few years developed a new generation of lasers, it not only inherits the YAG laser less bleeding, shorter operation time, trauma, etc, and also has equipment small size, high power, easy to operate, through the optical fiber into operation field, no cooling device, the advantages of moving at any time, by many scholars of all ages. Author with endoscopic guidance, vision clear, the back end of the nasal cavity lesions were visible range. In operation, the author found that the semiconductor laser has its own unique advantages. First, it overcomes ,CO2 laser can not be conducted by the shortcomings of optical fiber and semiconductor laser fiber small, flexible operation at any angle and inferior turbinate contact any shaping operation can be of inferior turbinate, nasal ventilation to expand the area to establish an effective airway. Second, with the YAG laser compared to the penetration depth of about 1 ~ 2 mm, while the YAG laser is 4 ~ 6 mm, so the surrounding tissue may result in less chance of injury, this group of patients after nasal edema and infiltration a relatively light, fewer dressing changes, patients recovered rapidly. Third, its a light touch can reduce the inconvenience of surgery in the light focus, not damage surrounding tissue, to facilitate accurate operation. Semiconductor laser wavelength 810nm, very close to the infrared part of the machine's electro-optical conversion rate is high, it solidified the role of blood vessels better. The gasification and solidification of the function to less bleeding. The group of 32 patients without bleeding in one case the situation more or repeated bleeding. However, allergic rhinitis or accompanied by severe septal deviation, turbinate bone hypertrophy, a simple semi-conductor laser treatment can not improve the nasal congestion, must be combined with other treatments.
In summary, I believe that semiconductor lasers with less damage, shorter operative time, less bleeding were mild, and rapid recovery, is a better means of treatment of chronic rhinitis.

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