Skip to main content
Log in

Diode laser–assisted inferior turbinoplasty in resistant cases of allergic rhinitis: a clinical and histopathological study

  • Original Article
  • Published:
Lasers in Medical Science Aims and scope Submit manuscript

Abstract

Chronic nasal obstruction owed to inferior nasal turbinate hypertrophy is one of the most common problems encountered in rhinology. When medical management fails, surgical reduction of hyperplastic inferior nasal turbinate is often used. Diode laser is appropriate for the use in the nasal turbinate. This study was designed to define the histopathologic changes in the inferior turbinate post diode laser turbinoplasty and evaluate the outcome in patients having allergic inferior turbinate hypertrophy that has not responded to the medical treatment. A prospective single-cohort study was carried out. Under general anesthesia, 18 patients underwent inferior turbinoplasty using diode laser 980 nm in the contact mode submucosally under guidance of a 4-mm nasal endoscope 0°. Inferior turbinate mucosa biopsy specimens were taken at the time of surgery, and after 3 months, they were histopathologically examined with assessment of the patients’ symptoms. At 3 months postoperatively, histopathologic assessment demonstrated marked structural changes in diode laser–treated inferior turbinates including the predominance of fibrous tissue with diminution of seromucinous glands, venous sinusoids, and inflammatory cell infiltrate. Concurrently, 16 patients (89%) had no nasal obstruction, 15 patients (83%) had moderate-to-good improvement of rhinorrhea, whereas 13 patients (72%) had moderate-to-good improvement of sneezing. Diode laser produces histopathologic changes in the inferior turbinate soft tissues, providing excellent ablation of the soft tissue with controllable performance and good hemostasis. Therefore, it is a safe, minimally invasive, and effective procedure in relieving nasal obstruction secondary to inferior turbinate hypertrophy as well as other symptoms of allergic rhinitis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Elwany SS, Stephanos WM (1983) Rhinitis medicamentosa. An experimental histopathological and histochemical study. ORL J Otorhinolaryngol Relat Spec 45(4):187–194

    Article  CAS  Google Scholar 

  2. Toppozada H, Toppozada M, El-Ghazzawi I, Elwany S (1984) The human respiratory nasal mucosa in females using contraceptive pills. An ultramicroscopic and histochemical study. J Laryngol Otol 98(1):43–51

    Article  CAS  Google Scholar 

  3. Passàli D, Passàli FM, Damiani V, Passàli GC, Bellussi L (2003) Treatment of inferior turbinate hypertrophy: a randomized clinical trial. Ann Otol Rhinol Laryngol 112(8):683–688

    Article  Google Scholar 

  4. Farmer SE, Eccles R (2006) Chronic inferior turbinate enlargement and the implications for surgical intervention. Rhinology 44(4):234–238

    CAS  PubMed  Google Scholar 

  5. Ophir D, Shapira A, Marshak G (1985) Total inferior turbinectomy for nasal airway obstruction. Arch Otolaryngol 111(2):93–95

    Article  CAS  Google Scholar 

  6. Saleh HA, Durham SR (2007) Perennial rhinitis. BMJ 335(7618):502–507

    Article  Google Scholar 

  7. Lanier B (2007) Allergic rhinitis: selective comparisons of the pharmaceutical options for management. Allergy Asthma Proc 28(1):16–19

    Article  Google Scholar 

  8. Ye T, Zhou B (2015) Update on surgical management of adult inferior turbinate hypertrophy. Curr Opin Otolaryngol Head Neck Surg 23(1):29–33

    PubMed  Google Scholar 

  9. Sroka R, Janda P, Killian T, Vaz F, Betz CS, Leunig A (2007) Comparison of long term results after Ho:YAG and diode laser treatment of hyperplastic inferior nasal turbinates. Lasers Surg Med 39(4):324–331

    Article  Google Scholar 

  10. Janda P, Sroka R, Baumgartner R, Grevers G, Leunig A (2001) Laser treatment of hyperplastic inferior nasal turbinates: a review. Lasers Surg Med 28(5):404–413

    Article  CAS  Google Scholar 

  11. Sapçi T, Sahin B, Karavus A, Akbulut UG (2003) Comparison of the effects of radiofrequency tissue ablation, CO2 laser ablation, and partial turbinectomy applications on nasal mucociliary functions. Laryngoscope 113(3):514–519

    Article  Google Scholar 

  12. Fukutake T, Kumazawa T, Nakamura A (1987) Laser surgery for allergic rhinitis. AORN J 46(4):756–761

    Article  CAS  Google Scholar 

  13. Hoque MR, Rasel A, Asad MK, Aich ML (2010) Turbinoplasty of hypertrophied inferior turbinate by diode laser. Bangladesh J Otorhinolaryngol 16(1):29–34

    Article  Google Scholar 

  14. Imamura S, Honda H (2003) Carbon dioxide laser vaporization of the inferior turbinate for allergic rhinitis: short-term results. Ann Otol Rhinol Laryngol 112(12):1043–1049

    Article  Google Scholar 

  15. Camacho M, Zaghi S, Certal V, Abdullatif J, Means C, Acevedo J, Liu S, Brietzke SE, Kushida CA, Capasso R (2015) Inferior turbinate classification system, grades 1 to 4: development and validation study. Laryngoscope 125(2):296–302

    Article  Google Scholar 

  16. Berger G, Gass S, Ophir D (2006) The histopathology of the hypertrophic inferior turbinate. Arch Otolaryngol Head Neck Surg 132(6):588–594

    Article  Google Scholar 

  17. Choi H, Lee J, Cho S (2018) Inferior turbinate surgery in sleep- disordered breathing patients with nasal obstruction: principles and various techniques. Sleep Medicine Research 9(1):20–25

    Article  Google Scholar 

  18. Bhat VS (2010) Histopathological study of hypertrophied inferior turbinate. International J Health Sciences and Research 5(1):51–58

    Google Scholar 

  19. Chang CD, Ries WR (2004) Surgical treatment of the inferior turbinate: new techniques. Curr Opin Otolaryngol Head Neck Surg 12(1):53–57

    Article  CAS  Google Scholar 

  20. Hegazy MA, Mohamed AS, El-Hennawy AY, El-Fouly MS (2014) Histopathological study of hypertrophic inferior turbinate. Egyptian J Otolaryngol 30(1):23–29

    Article  Google Scholar 

  21. Wexler DB, Berger G, Derowe A, Ophir D (2001) Long-term histologic effects of inferior turbinate laser surgery. Otolaryngol Head Neck Surg 124(4):459–463

    Article  CAS  Google Scholar 

  22. Elwany S, Abel Salaam S (1999) Laser surgery for allergic rhinitis: the effect on seromucinous glands. Otolaryngol Head Neck Surg 120(5):742–744

    Article  CAS  Google Scholar 

  23. Gupta P, Kc T, Regmi D (2018) Diode laser turbinate reduction in allergic rhinitis: a cross-sectional study. JNMA J Nepal Med Assoc 56(214):949–952

    Article  Google Scholar 

  24. Ibrahim AH, Mutar AC, Abutiheen AAK (2017) Diode 1470 nm laser turbinoplasty versus partial surgical inferior turbinectomy for treatment of inferior turbinate hypertrophy. Karbala J Medicine 10(3):3810–3817

    Google Scholar 

  25. Parida PK, Surianarayanan G, Alexander A, Saxena SK, Santhosh K (2013) Diode laser turbinate reduction in the treatment of symptomatic inferior turbinate hypertrophy. Indian J Otolaryngol Head Neck Surg 65(Suppl 2):350–355

    Article  Google Scholar 

  26. Berger G, Hammel I, Berger R, Avraham S, Ophir D (2000) Histopathology of the inferior turbinate with compensatory hypertrophy in patients with deviated nasal septum. Laryngoscope 110(12):2100–2105

    Article  CAS  Google Scholar 

  27. Schmidt J, Zalewski P, Olszewski J, Olszewska-Ziaber A (2001) Histopathological verification of clinical indications to partial inferior turbinectomy. Rhinology 39(3):147–150

    CAS  PubMed  Google Scholar 

  28. Kim D, Baraniuk JN (2007) Neural aspects of allergic rhinitis. Curr Opin Otolaryngol Head Neck Surg 15(4):268–273

    Article  Google Scholar 

  29. Garzaro M, Landolfo V, Pezzoli M, Defilippi S, Campisi P, Giordano C, Pecorari G (2012) Radiofrequency volume turbinate reduction versus partial turbinectomy: clinical and histological features. American J Rhinology Allergy 26(4):321–325

    Article  Google Scholar 

  30. Caffier PP, Scherer H, Neumann K, Lück S, Enzmann H, Haisch A (2011) Diode laser treatment in therapy-resistant allergic rhinitis: impact on nasal obstruction and associated symptoms. Lasers Med Sci 26(1):57–67

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Waleed Mohamed Basha Amin Khamis.

Ethics declarations

Ethics approval

The Institutional Reviewer Board (IRB) of the Faculty of Medicine, Zagazig University, Egypt, has approved the study.

Informed consent

A fully informed written consent was obtained from all patients included in the study.

Consent for publication

This manuscript is original, has not been previously published, and is not under consideration for publication elsewhere. This manuscript has not been presented in any meeting.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mohamed, N.N., Khamis, W.M.B.A., Abdelbary, E.H. et al. Diode laser–assisted inferior turbinoplasty in resistant cases of allergic rhinitis: a clinical and histopathological study. Lasers Med Sci 37, 2053–2061 (2022). https://doi.org/10.1007/s10103-021-03477-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10103-021-03477-w

Keywords

Navigation