Efficacy of seasonal allergic rhinitis using an 810 nm diode laser system.

BACKGROUND AND AIMS: Allergic rhinitis annually reach epidemic proportions in Japan. Approximately 30 to 40% of the population suffers from allergic rhinitis during the spring season. Symptoms comprise rhinorrhea, nasal congestion, and sneezing accompanied by irritation and itching of the eyes. The Ohshiro Clinic started using the conventional Nd:YAG laser for the treatment of allergic rhinitis in 1993, and from 2005 we started using a diode laser-pumped Nd:YAG laser. From 2010, we adopted a novel 810 nm diode laser, and the present retrospective study examined the efficacy rate of the treatment of allergic rhinitis in the 2018 season with this system, compared with a previous study in 2011. We aimed to confirm the degree of improvement for each symptom to evaluate effectiveness of the diode laser treatment. SUBJECTS AND METHODS: Between January 8, 2018 and April 30, 2018, a large number of patients consulted our clinic with the major complaint of seasonal allergic rhinitis. They underwent a blood test, and the antigen-specific serum IgE antibody titers were measured for a definitive diagnosis of cedar pollinosis. A total of 211 target patients were treated during the trial period. The average age of the target group was 36.3 years, 134 males, and 77 females. The target patients were treated with lower nasal turbinate mucosal irradiation using a diode laser (ADL-20, Asuka Medical) delivering 810 nm at 7.5 W, with a total energy per treatment of 240 J/cm2. We adopted a five-step evaluation in accordance with the Japanese Guidelines for Allergic Rhinitis 2014 for the symptoms of rhinorrhea, sneezing and nasal obstruction. We assessed the degree of improvement in the severity of these symptoms following diode laser treatment from baseline to one month after treatment, in addition to assessing patient satisfaction with the degree of improvement in their quality of life (QOL). RESULTS: The 211 patients positive for cedar pollinosis by the antigen-specific serum IgE antibody tests were broken down by month by number and by improvement, no change or exacerbation as follows. January, 18 patients: 33.4%, 44.4% and 22.2%, respectively. February, 29: 10.4%, 44.4% and 22.2%, respectively. March, 146: 60.3%, 31.5% and 8.2%, respectively. April, 18: 77.8%, 16.7% and 5.5%, respectively. The monthly respective improvement, no change or worse patient QOL as percentages were as follows: January: 16.7%, 44.4% and 38.9%. February: 17.3%, 13.8% and 68.9%. March: 61.6%, 29.5% and 8.9%. April: 94.4%, 0.0% and 5.6%. The values for prevention of exacerbation versus exacerbation for each month were: January, 77.8% vs 22.2%; February, 41.4% vs 58.6%; March, 91.8% vs 8.2%; and April, 94.4% vs 5.6%. The mean efficacy rate for the trial period in the present study was therefore 52.6% which compared very favorably with the mean efficacy rate in the 2011 study of 53.4%. CONCLUSIONS: The results showed that the 810 nm diode laser offered a safe and effective solution for the uncomfortable symptoms of allergic rhinitis and could be well applied during the season of Japanese cedar pollen dispersion. Furthermore, a tendency towards high efficacy was demonstrated for laser treatment in class 6 cedar pollinosis patients, based on the specific IgE antibody test.

The effect of low level laser therapy for pain in major muscles controlling two joints.

BACKGROUND AND AIMS: Chronic pain is a significant health care problem which is often encountered in medical institute out-patient clinics . In previous studies we have reported on the benefits of low level laser therapy (LLLT) for chronic musculoskeletal pain patients. The present study is a report on the effects of LLLT in patients with pain in major muscles which govern the motion of two joints (2-joint muscles). MATERIALS AND METHODS: Over the past 5 years, 19 subjects visited our out-patient clinic with complaints of pain in 2-joint muscles (biceps brachii muscle or gastrocnemius muscle). They were treated with LLLT using a 1000 mW semi-conductor laser device delivering 20.1 J/cm2 per point at 830 nm in continuous wave. Four shots were given per session (1 treatment) twice a week for 2 months (total of 16 treatments). RESULTS: A treatment approach modified from the methods of Shiroto and Ohshiro, was used, and the efficacy of LLLT for pain attenuation in the affected muscle was determined. After the end of the treatment regimen, excellent and good improvement was observed in 16 patients out of 19. Discussions with the patients revealed that it was important for them to learn how to modify their everyday life to avoid posture and activities of daily life that could cause them pain in the 2-joint muscles, in order to enjoy continuous benefits from the treatment. CONCLUSION: The present study demonstrated that LLLT was an effective form of treatment for pain in the biceps brachii and gastrocnemius muscles. To maximize and prolong treatment efficacy, advice should be given to patients to avoid adopting any posture and activities of daily living which would cause pain in these specific muscles.

Retrospective Study on Laser Treatment of Oral Vascular Lesions Using the "Leopard Technique": The Multiple Spot Irradiation Technique with a Single-Pulsed Wave.

OBJECTIVE: This study aimed to retrospectively evaluate the efficacy and safety of laser treatment of oral vascular lesions using the multiple spot irradiation technique with a single-pulsed wave. BACKGROUND DATA: In laser therapy for vascular lesions, heat accumulation induced by excessive irradiation can cause adverse events postoperatively, including ulcer formation, resultant scarring, and severe pain. To prevent heat accumulation and side effects, we have applied a multiple pulsed spot irradiation technique, the so-called "leopard technique" (LT) to oral vascular lesions. This approach was originally proposed for laser treatment of nevi. It can avoid thermal concentration at the same spot and spare the epithelium, which promotes smooth healing. The goal of the study was to evaluate this procedure and treatment outcomes. PATIENTS AND METHODS: The subjects were 46 patients with 47 oral vascular lesions treated with the LT using a Nd:YAG laser (1064 nm), including 24 thick lesions treated using a combination of the LT and intralesional photocoagulation. RESULTS: All treatment outcomes were satisfactory without serious complications such as deep ulcer formation, scarring, bleeding, or severe swelling. CONCLUSIONS: Laser therapy with the LT is a promising less-invasive treatment for oral vascular lesions.

Low Level Laser Therapy for Radial Nerve Palsy Patients : Our Experience.

BACKGROUND AND AIMS: Peripheral nerve injury is one of the frequent complaints which is seen in the outpatient clinic of our medical institute. In previous studies we have reported on the benefits of low level laser therapy (LLLT) for central nerve system disorders, namely cerebrovascular accidents and cerebral palsy. The present study is a report on our experience of the effects of LLLT for peripheral nerve palsy. MATERIALS AND METHODS: Over the past 5 years, 13 subjects visited the out-patient clinic with the chief complaint of radial nerve palsy caused by compression of the nerve through with abnormal positioning, and sleeping posture at night. The patients were treated with LLLT. A 1000 mW semi-conductor laser device was used, delivering 830 nm in continuous wave at a dose of 20.1 J/cm2 /point, and five points were treated per session (i.e., 1 treatment) twice a week for 3 months (total 24 treatments). In 6 patients LLLT was combined with brace therapy. RESULTS: Modified Daniels' manual muscle testing was used to determine the effects of LLLT for the muscle power of the extensor carpi radialis, and on completing the treatment regimen excellent improvement was observed in 9 cases out of 13. Combination treatment (laser therapy with bracing) resulted in 4 excellent cases out of 6 cases. Discussions with the patients clarified that it was important for them to learn how to avoid the particular posture that could cause them radial nerve palsy in daily life in order to have continuous benefits from the treatment. CONCLUSION: The present study demonstrated that LLLT was an effective form of treatment for radial nerve palsy. In addition, patients were advised to avoid any incorrect posture which might induce radial nerve palsy.

Usefulness of picosecond pulse alexandrite laser treatment for nevus of Ota.

BACKGROUND AND AIMS: Recently, novel picosecond pulse duration lasers (ps-lasers) have been developed for the treatment of multicolored and recalcitrant tattoos, and safety and efficacy have been reported. We therefore hypothesized that ps-lasers could be an alternative treatment for dermal pigmented lesions. We performed a retrospective review to evaluate the efficacy and safety of the ps-laser for nevus of Ota. SUBJECTS AND METHODS: A retrospective photographic review of 15 patients with nevus of Ota was performed (ages from 10 months to 65 yr). The patients were treated in the Ohshiro Clinic with a picosecond-domain 755 nm alexandrite laser (ps-Alex laser) from June 2015 to August 2017. Improvement was evaluated as the percentage of pigmentation clearance comparing the baseline findings with those at 3 months after the final treatment using a four category grading scale: Poor, 0-24%; Fair, 25-49%; Good, 50-74%; and Excellent 75-100% improvement. Adverse events were also assessed. RESULTS: All patients obtained clinical improvement ranging from fair to excellent. All 5 patients whose primary treatment was the ps-Alex laser obtained excellent in 2-3 treatment sessions (average 2.5 sessions), and the average total treatment span was 10.0 months. Treatment with the ps-Alex laser caused transient hyperpigmentation followed by improvement to complete resolution at 3 months of follow-up. CONCLUSIONS: Our results suggest that 755 nm ps laser treatment is efficacious for the treatment of nevus of Ota with minimum adverse events.

Type 2 Minocycline-induced hyperpigmentation successfully treated with the novel 755 nm picosecond alexandrite laser - a case report.

BACKGROUND AND AIM: Minocycline therapy for acne vulgaris is associated with the occasional induction of various types of unsightly and often persistent hyperpigmentation, which is frequently resistant to hydroquinone treatment. Pigment-specific lasers have achieved some success with multiple treatment sessions. Recently, the picosecond domain 755 nm alexandrite laser (ps-Alex) has attracted attention in tattoo removal. The present study reports on the successful treatment, in a single ps-Alex session, of minocycline-associated pigmentation. SUBJECT AND METHOD: Subsequent to a course of minocycline, a 28-year-old Asian female developed persistent type 2 minocycline-related pigmentation on the bilateral lower extremities which was recalcitrant to hydroquinone treatment. The patient had a test treatment on a small area with a Q-switched ruby laser and the ps-Alex, following which the ps-Alex was selected for the actual treatment (spot size, 2 mm; fluence, 6.37 J/cm2; pulsewidth, 750 ps) on one leg first, followed later by the contralateral leg. RESULTS: Rapid clearance of the pigmentation was noted after a single ps-Alex session on both limbs without prolonged post-inflammatory hyperpigmentation (PIH). At one year post-treatment, clearance had been maintained. CONCLUSIONS: Our results in this single case strongly suggest that the novel 755-nm ps-Alex laser is both safe and very effective for the treatment of type 2 minocycline-induced hyperpigmentation even in PIH-prone type IV Asian skin. Further trials with larger patient populations are warranted to confirm this optimistic result.

Low Level Laser Therapy in patients with chronic foot and ankle joint pain.

BACKGROUND AND AIMS: Chronic foot and ankle joint pain is one of the most frequent complaints which is regularly seen in the out-patient clinic of our medical institute. In previous studies we have reported on the benefits of low level laser therapy (LLLT) for chronic pain in the elbow, hand, finger and the lower back. The present study examined the effects of LLLT on chronic foot and ankle joint pain. MATERIALS AND METHODS: Over the past 5 years, 17 subjects visited the out-patient clinic with complaints of chronic foot and ankle joint pain of a variety of aetiologies. The patients received LLLT using a 1000 mW semi-conductor laser device, delivering 20.1 J/cm2 per point at 830 nm in continuous wave. Each patient was given four shots per session per foot twice a week for 4 weeks. RESULTS: A visual analogue scale (VAS) was used to determine the effects of LLLT for the chronic pain and after the end of the treatment regimen a significant improvement was observed (p < 0.01). All but 2 of the patients showed improvement: excellent (2) and good (13). After treatment, no significant differences were observed in the ankle joint range of motion, however. Discussions with the patients revealed that it was important for them to learn how to avoid overuse of the ankle when walking, poor walking posture and a poor pacing technique that would caused them foot and ankle pain in everyday life. Following these postural guidelines could ensure continuous benefits from the treatment. CONCLUSION: The present study demonstrated that LLLT was an effective form of treatment for chronic foot and ankle joint pain, in conjunction with postural education during all activities of daily living.