Diode laser treatment in therapy-resistant allergic rhinitis: impact on nasal obstruction and associated symptoms

Abstract

The ideal treatment in severe obstructive allergic rhinitis unresponsive to standard therapy is lacking. This study aimed to evaluate the efficacy of endonasal corrective laser surgery in perennial (pAR) and seasonal (sAR) allergic rhinitis. Forty subjects (20 pAR, 20 sAR) underwent videoendoscopic diode laser surgery. Examinations were performed preoperatively and at follow-ups 1, 12, and 24 months after surgery, including objective parameters (rhinomanometry, videoendoscopy, allergy tests) and subjective visual analog scales (evaluation of surgery, satisfaction, allergic symptoms). Of all patients, 95% received inferior turbinate, 40% septal, and 15% middle turbinate surgery. Postoperatively, two subjects showed considerable residual symptomatology (95% response rate). Throughout follow-up, objective rhinomanometry and subjective scores for nasal obstruction, rhinorrhea, sneezing, itching, and overall satisfaction improved significantly with time (p < 0.0005). The improvement was greatest for nasal obstruction, initially higher in pAR but more sustained in sAR. After 2 years, 30% sAR and 40% pAR subjects had been receiving pharmacotherapy due to recurrent symptoms. The allergic condition remained unchanged (skin and in-vitro tests). Outpatient endonasal diode laser surgery appears to be effective, safe and well tolerated for treating otherwise therapy-resistant pAR and sAR, providing long-lasting symptom reduction with complete stop or decreased use of antiallergics.

Diode Laser Turbinate Reduction in Allergic Rhinitis: A Cross-sectional Study

“…The operating time ranged from two to twelve minutes. 5,7,8,10,11 Significant improvement was noted by three months time. The reported complications included intraoperative bleeding, postoperative blood mixed nasal secretions, pain, doi: 10.31729/jnma.3644 CC BY doi: 10.31729/jnma.3870 CC BY crusting and synechia.…”

“…The reported complications included intraoperative bleeding, postoperative blood mixed nasal secretions, pain, doi: 10.31729/jnma.3644 CC BY doi: 10.31729/jnma.3870 CC BY crusting and synechia. [6][7][8]10,11 There are limited studies on diode LTR in Indian subcontinent. [6][7][8] This study aimed to evaluate the efficacy of diode LTR in medical therapy resistant allergic rhinitis and encourage its use among care providers.…”

Diode laser assisted minimal invasive sphenoidotomy for endoscopic transphenoidal pituitary surgery: Our technique and results

“…It may create a blood‐free environment in the spheno‐ethmoidal recess to reduce the occurrence of complications. The diode laser was utilized with the advantage of marked hemostatic effects and interactions with tissues to obtain good excision effects . It also provides a depth of penetration sufficient to remove tissue with the underlying important structures surrounding the sinuses preserved and protected.…”

Surgery for allergic rhinitis

“…The laser may be applied in a spot or linear fashion, anterior‐to‐posterior stripes, cross‐hatching across the entire mucosal surface, or along only the anterior or inferior aspect of the turbinate . Caffier et al reported on the effects of diode laser turbinoplasty in 40 patients afflicted with AR. Statistically significant improvements occurred in rhinomanometry and nasal obstruction, rhinorrhea, sneezing, and nasal pruritus.…”