Clinical feasibility trial on 1940 nm Tm: Fiber laser intervention of hyperplastic inferior nasal turbinates

Abstract

Introduction: A number of different laser systems have been used for volume reduction of hyperplastic nasal turbinates. In case of endonasal application, fiber-controlled diode lasers are preferred due to reasons of cost and practicability. The aim of this clinical feasibility study was to show the coagulative and tissue reducing effects using a novel Tm: fiber laser system emitting at λ = 1940 nm. Patients and methods: This clinical feasibility trial included 11 patients suffering from hyperplastic inferior nasal turbinates, who were therapy-refractory to conservative medical treatment. The obstructive nasal cavity was treated using the 1940 nm Tm: fiber laser at < 5 W output power. The treatment was performed in non-contact mode under endoscopic control. Patients ' symptoms were documented both preoperatively and on days 1 - 3 and 28 post operatively using a non-validated questionnaire. Additionally, an endoscopic examination was performed. Results: None of the patients showed infections, and no hemorrhages or other complications occurred intra- or postoperatively. The mean laser activation time during the surgical procedure was extremely short being 28.0 ± 8.5 s. In conjunction with a low power setting (median, 3 W; mean ± standard deviation, 3.3 ± 1.1 W), a low energy of 90.2 ± 37.8 J was applied. A significant reduction in nasal obstruction could be documented in all patients on day 28 postoperatively. Evaluation, as assessed preoperatively and 4 weeks postoperatively, showed significant subjective improvements. Conclusion: The treatment of hyperplastic inferior turbinates using a 1940 nm Tm: fiber laser provides sufficient tissue reduction in a short operation time using low total energy. Patients described a significant improvement in nasal breathing postoperatively.