Erste Anwendungsergebnisse des Wave-Guide bei der CO2-laserchirurgischen Verkleinerung der hyperplastischen Nasenmuscheln

BACKGROUND The CO2-laser-surgical reduction of the hyperplastic nasal turbinates represents a standard procedure in ENT-Surgery. In the presented paper, the authors introduce a new technique for the treatment of hyperplastic turbinates. METHODS The laser beam is transmitted through a 90 degrees handpiece to the mobile "infra-guide" wave guide, which contains a 1 mm ceramic tube. By application of mirrow pieces with different angles, laser surgical reduction of those parts of the nasal turbinates is possible, which normally can not be reached by conventional, tangentially to the mucosa directed laser beams. The direction of the laser beam is controlled either optically, as in endonasal sinus surgery, or monitored through a camera. A total of 36 patients (22 women, 14 men, mean age 32.7 years) with nasal turbinate hyperplasia and either impaired nasal breathing and/or retronasal drip were treated with the new method. RESULTS The laser wave guide represents a minimally invasive and basically complication-free method feasable on an outpatient basis. As a particular advantage, laser surgical reduction of the posterior parts of the inferior and also the middle turbinate is possible. The majority of the patients relates of an improvement of the preoperative symptoms (regarding reduction of impaired nasal breathing: 61.3 %, regarding reduction of post nasal drip 87.1 %). CONCLUSION The laser wave-guide represents a basically complication-free, minimally invasive supplement to the different treatment modalities of the hyperplastic nasal turbinates.