A comperative clinical study of mucotomy and KTP laser treatment of the inferior turbinate in allergic and non-allergic subjects

Abstract

Mucotomy is one of the most frequently applied surgical techniques for the management of inferior turbinate hyperplasia. Mucotomy guarantees patent airway, however, it might lead to the emergence of sicca syndrome. In contrast, KTP (potassium titanyl phosphate) laser treatment spares the medial part of the inferior turbinate mucosa, contributing to maintenance of physiological nasal function. A retrospective comparative clinical study was performed to reveal the advantages and side-effects of both surgical methods in medium- and long-term in allergic rhinitis and non-allergic patients. Furthermore, we wished to determine the exact indications of the up-to-date laser treatment. Ninety-one of the 117 patients who underwent bilateral turbinate surgery during an 8-year period (2000-2007) responded to our questionnaire focusing on subjective postoperative changes. Patients were separated into 6 groups, based on the type of operation they underwent, the length of the follow-up and whether they suffered from allergies. The major complaint, nasal obstruction, improved in all 6 groups, which reached significance (p ? 0.05) in 4 groups. The most pronounced improvement was observed in the group of non-allergic patients with medium-term follow-up who underwent mucotomy. Nevertheless, a serious side- effect: crusting also increased significantly (p ? 0.05) in the latter group, while it was absent in allergic patients with medium-term follow-up, who underwent mucotomy. These results lead us to propose the following protocol for the treatment of inferior turbinate hyperplasia: 1) after unsuccessful conservative treatment, laser treatment is suggested for non-allergic patients; 2) following unsuccessful conservative and even repeated laser treatment in the allergic group, mucotomy or turbinoplasty should be attempted.