Efficacy of seasonal allergic rhinitis using an 810 nm diode laser system

Abstract

Background and Aims: Allergic rhinitis annually reach epidemic proportions in Japan. Approximately 30 to 40% of the population suffers from allergic rhinitis during the spring season. Symptoms comprise rhinorrhea, nasal congestion, and sneezing accompanied by irritation and itching of the eyes. The Ohshiro Clinic started using the conventional Nd:YAG laser for the treatment of allergic rhinitis in 1993, and from 2005 we started using a diode laser-pumped Nd:YAG laser. From 2010, we adopted a novel 810 nm diode laser, and the present retrospective study examined the efficacy rate of the treatment of allergic rhinitis in the 2018 season with this system, compared with a previous study in 2011. We aimed to confirm the degree of improvement for each symptom to evaluate effectiveness of the diode laser treatment. Subjects and methods: Between January 8, 2018 and April 30, 2018, a large number of patients consulted our clinic with the major complaint of seasonal allergic rhinitis. They underwent a blood test, and the antigen-specific serum IgE antibody titers were measured for a definitive diagnosis of cedar pollinosis. A total of 211 target patients were treated during the trial period. The average age of the target group was 36.3 years, 134 males, and 77 females. The target patients were treated with lower nasal turbinate mucosal irradiation using a diode laser (ADL-20, Asuka Medical) delivering 810 nm at 7.5 W, with a total energy per treatment of 240 J/cm 2 . We adopted a five-step evaluation in accordance with the Japanese Guidelines for Allergic Rhinitis 2014 for the symptoms of rhinorrhea, sneezing and nasal obstruction. We assessed the degree of improvement in the severity of these symptoms following diode laser treatment from baseline to one month after treatment, in addition to assessing patient satisfaction with the degree of improvement in their quality of life (QOL). Results: The 211 patients positive for cedar pollinosis by the antigen-specific serum IgE antibody tests were broken down by month by number and by improvement, no change or exacerbation as follows.

Outcomes of endoscopic chemo- and laser-cauterizations and open fistulectomy for pyriform sinus fistula

“…ELC was performed using a Diode Laser System ADL-20 (Asuka Medical Inc., Kyoto, Japan) that generates 810-nm wavelength diode laser [ 11 ]. The diode laser is guided through a glass fiber.…”

“…We thought that this system would be appropriate to cauterize the mucosa of the fistula selectively. The device has been approved by the Ministry of Health, Labor and Welfare and is covered by the healthcare insurance system in Japan to use for cutting, coagulating, and establishing hemostasis during surgical, otolaryngological [ 11 ], and bronchoscopic treatments. Prior to clinical use, we conducted a pre-clinical experiment using a raw chicken esophagus to test the amount of heat needed to cauterize the mucosal layer selectively, with minimal heat denaturing of the muscle layer (Fig.…”

“…To improve the success rate, we adopted an endoscopic laser-cauterization (ELC) system, Diode Laser System ADL-20 (Asuka Medical Inc., Kyoto, Japan), in 2015. The Diode Laser System ADL-20 was previously used for endovascular laser photocoagulation therapy for the patients with chronic venous insufficiency, resulting in excellent clinical and safety outcomes [ 11 ]. The usual aim of laser treatments, such as CO 2 lasers, is to irradiate lesions directly with a laser, but this comes with a risk of cauterizing not only the mucous membrane but also the deep tissues.…”

Medical devices in allergy practice

“…The technology has now been refined, and 810 nm diode laser has been demonstrated to offer relief of symptoms to allergic rhinitis sufferers when applied before or during the Japanese cedar pollen season. 191,192 High-intensity focused ultrasound therapy Devices generating ultrasound with specific characteristics have been found to be effective in reducing eosinophil loaded tissues and structures in the nasal cavity, to reduce inferior turbinate hypertrophy and improve ventilation. 193,194…”

“…The technology has now been refined, and 810 nm diode laser has been demonstrated to offer relief of symptoms to allergic rhinitis sufferers when applied before or during the Japanese cedar pollen season. 191 , 192 …”