Laser Surgery for Perennial Nasal Allergy. 3rd Report; Its Mechanism.

Laser Surgery for Allergic and Hypertrophic Rhinitis

“…In a study on CO2 laser surgery, Fukutake et al 4 investigated changes in thresholds in provocation tests of the nasal mucosa and of eosinophils in nasal discharge in 34 cases that showed favorable results 1 year after surgery, and reported that an increase in threshold and a decrease in eosinophils were shown by the provocation test after surgery and that histologie changes of the superficial layer of the nasal mucosa due to laser surgery suppressed the antigen- antibody reaction. Further, Kawamura et al, 5 who also performed C02 laser surgery, investigated increases and decreases in eosinophilic cationic protein (ECP) in irrigation solution due to the provocation of antigen before and after surgery, and confirmed a decrease in ECP in the group in which the symptoms improved, indicating suppression of release of a chemical mediator associated with squamatization of the epithelium of the nasal mucosa as one of the factors in the effectiveness of laser surgery. The findings of both of these studies are consistent with our experience.…”

“…Moreover, they reported that an improvement in the hemodynamics of the nasal mucosa was observed, and vascularization was confirmed histopathologically in the superficial layer of the lamina propria mucosa. In addition, by measuring blood flow volume on the mucosal surface using a laser Doppler method, Kawamura et al 5 reported that blood flow volume in the nasal mucosa in patients with nasal allergy was significantly decreased compared to that in normal volunteers before surgery, and tended to further decrease after surgery. They considered that blood flow in the nasal mucosa decreased due to ischemia, and that interstitial edema might be further decreased because of the substitution of poorly vascularized cicatricial tissue.…”

Changes in Nasal Responsiveness to Histamine and to Specific Antigen after Laser Surgery

“…Kawamura et al have reported that the amount of eosinophil cationic protein (ECP) in the nasal lavage fluid significantly decreased after laser surgery in almost all patients, especially in those with a very good response to surgery (11). Some reports indicate that basic proteins such as ECP and major basic proteins released from the activated eosinophils are involved in the enhancement of non-specific hyper-reactivity in bronchial asthma and in nasal allergy (12,13).…”