Towards reliable diagnostics of prostate cancer via breath.

Early detection of cancer is a key ingredient for saving many lives. Unfortunately, cancers of the urogenital system are difficult to detect at early stage. The existing noninvasive diagnostics of prostate cancer (PCa) suffer from low accuracy (< 70%) even at advanced stages. In an attempt to improve the accuracy, a small breath study of 63 volunteers representing three groups: (1) of 19 healthy, (2) 28 with PCa, (3) with 8 kidney cancer (KC) and 8 bladder cancer (BC) was performed. Ultrabroadband mid-infrared Fourier absorption spectroscopy revealed eight spectral ranges (SRs) that differentiate the groups. The resulting accuracies of supervised analyses exceeded 95% for four SRs in distinguishing (1) vs (2), three for (1) vs (3) and four SRs for (1) vs (2) + (3). The SRs were then attributed to volatile metabolites. Their origin and involvement in urogenital carcinogenesis are discussed.

Micro-endoscopy of the human vas deferens: a feasibility study of a novel device in several ex vivo models.

The aim of this study was to show limitation as well as potential of micro-endoscopy techniques as an innovative diagnostic and therapeutic approach in andrology. Two kinds of custom-made micro-endoscopes (ME) were tested in ex vivo vas deferens specimen and in post-mortem whole body. The semi-rigid ME included a micro-optic (0.9 mm outer diameter [OD], 10.000 pixels, 120° vision angle [VE], 3-20 mm field depth [FD]) and an integrated fibre-optic light source. The flexible ME was composed of a micro-optic (OD = 0.6 mm, 6.000 pixels, 120° VE, 3-20 mm FD). The ex vivo study included retrograde investigation of the vas deferens (surgical specimen n = 9, radical prostatectomy n = 3). The post-mortem investigation (n = 4) included the inspection of the vas deferens via both approaches. The results showed that antegrade and retrograde rigid endoscopy of the vas deferens were achieved as a diagnostic tool. The working channel enabled therapeutic use including biopsies or baskets. Using the flexible ME, the orifices of the ejaculatory ducts were identified. In vivo cadaveric retrograde cannulation of the orifices was successful. Post-mortem changes of verumontanum hindered the examinations beyond. Orifices were identified shaded behind a thin transparent membrane. Antegrade vasoscopy using flexible ME was possible up to the internal inguinal ring. Further advancement was impossible because of anatomical angle and lack adequate vision guidance. The vas deferens interior was clearly visible and was documented by pictures and movies. Altogether, the described ME techniques were feasible and effective, offering the potential of innovative diagnostic and therapeutic approaches for use in the genital tract. Several innovative indications could be expected.

Efficacy of retrograde ureteropyeloscopic holmium laser lithotripsy for intrarenal calculi >2 cm.

The objectives of this study are to assess the efficacy and safety of retrograde ureteroscopic holmium laser lithotripsy for intrarenal calculi greater than 2 cm in diameter. A total of 24 patients with a stone burden >2 cm were treated with retrograde ureteroscopic laser lithotripsy. Primary study endpoints were number of treatments until the patient was stone free and perioperative complications with a follow-up of at least 3 months after intervention. In 24 patients (11 women and 13 men, 20-78 years of age), a total of 40 intrarenal calculi were treated with retrograde endoscopic procedures. At the time of the initial procedure, calculi had an average total linear diameter of 29.75 ± 1.57 mm and an average stone volume of 739.52 ± 82.12 mm(3). The mean number of procedures per patient was 1.7 ± 0.8 (range 1-3 procedures). The overall stone-free rate was 92%. After 1, 2 and 3 procedures 54, 79 and 92% of patients were stone free, respectively. There were no major complications. Minor postoperative complications included pyelonephritis in three cases (7.5%), of whom all responded immediately to parenteral antibiotics. In one patient the development of steinstrasse in the distal ureter required ureteroscopic fragment disruption and basketing. Ureteroscopy with holmium laser lithotripsy represents an efficient treatment option and allows the treatment of large intrarenal calculi of all compositions and throughout the whole collecting system even for patients with a stone burden of more than 2 cm size.

Explosive gas formation during transurethral resection of the prostate (TURP).

Intravesical explosion during transurethral resection of the prostate (TURP) is an extremely rare event. It might be associated with various degrees of bladder injury ranging from simple mucosal tear to rupture of the bladder. It is believed that intravesical explosion occurs due to formation of explosive gases in the bladder during TURP and its admixture with air. One case of intravesical explosion during TURP resulting in complete intra- and extraperitoneal bladder rupture at our institution is described. The management of this dreaded complication involves open surgery. Although rare, this complication is preventable by taking precautions.

[Diode laser. Ex vivo studies on vaporization and coagulation characteristics]. / Der Diodenlaser. Ex-vivo-Untersuchungen zu den Vaporisations- und Koagulationseigenschaften.

INTRODUCTION AND OBJECTIVES: Laser therapy of symptomatic benign prostatic hyperplasia (BPH) remains a challenge for most urologic surgeons. The main goal of laser surgery is to achieve a marked volume reduction and to decrease bladder outlet obstruction and lower urinary tract symptoms with minimal morbidity. Laser therapy encompasses a variety of techniques using different laser wavelengths, application systems, and surgical techniques to achieve contrasting tissue effects. In an in vitro animal model we compared the vaporization and coagulation effects of the potassium-titanyl-phosphate (KTP) laser, holmium:yttrium-aluminum-garnet (Ho:YAG) laser, and diode laser (980 nm). MATERIAL AND METHODS: In an in vitro model using isolated perfused porcine kidneys we investigated the vaporization, the coagulation effect, and the bleeding rate of the KTP, Ho:YAG, and diode lasers on five porcine kidneys each. The application of each laser type was standardized. The area of laser application was 1 cm x 1 cm. The KTP group received an application with 80 W, the Ho:YAG group an application with 10-30 W, and the diode group an application with 30, 60, and 100 W. Hemostasis was measured semiquantitatively. Ablation and coagulation were investigated macro- and microscopically. RESULTS: Concerning the ablation capacity, the diode laser is most effective (more than fivefold) compared to the KTP and Ho:YAG lasers but demonstrated a rather large coagulation zone of up to tenfold in comparison to the KTP and Ho:YAG lasers. Semiquantitatively, in terms of bleeding rate, all lasers were equivalent in this ex vivo model. CONCLUSIONS: Our very early and limited experience indicates that KTP (80 W) and Ho:YAG (30 W) laser application are equivalent in terms of tissue ablation capacity and coagulation in an experimental setting. The diode laser at 980 nm is superior in terms of ablation capacity but has a large coagulation zone. Concerning the bleeding rate all tested lasers are equivalent in this ex vivo model.

[Low-dose rate brachytherapy with locally integrated beta emitters after internal urethrotomy. A pilot project using an animal model]. / Low-dose-rate-Brachytherapie durch lokal integrierte Betastrahler nach Urethrotomia interna. Ein Pilotprojekt im Tierversuch.

BACKGROUND: The treatment of urethral strictures represents an unsolved urological problem. PATIENTS AND METHODS: The effect of a (32)P-coated urethral catheter in the sense of low-dose rate brachytherapy to modulate wound healing will be analyzed in an animal experiment. RESULTS: Unfortunately it is not possible to present any results because this is being studied for the first time and there are no experiences with low-dose rate brachytherapy and this form of application in the lower urinary tract. Furthermore the animal experiment will only start in the near future. Both decade-long experiences with radiotherapy to treat benign diseases and our own results of previous studies in otolaryngology and ophthalmology let us expect a significantly lower formation of urethral strictures after internal urethrotomy. CONCLUSION: This study will contribute to improving the treatment of urethral strictures as demanded in previous papers.

[Technical aspects of intraoperative assessment of treatment progress in laser lithotripsy]. / Technische Aspekte zur intraoperativen Bewertung des Behandlungsfortschritts bei der Laserlithotripsie.

BACKGROUND: During laser-induced fragmentation, differences in assessing the intraoperative results can depend on the individual characteristics of the laser system used. METHODS: Laser parameters like pulse energy and repetition rate, the penetration depth in silicon tissue, and the laser beam width on photographic paper were determined for three different clinical laser systems. RESULTS: Pulse energy and repetition rate were subject to variations depending on the laser system employed. Significant differences between the three devices were found for penetration depth in silicon and interaction. CONCLUSIONS: Further investigations to ascertain the ablation threshold and fragmentation rate can be based on these findings. Intraoperative assessment of the lithotripsy results should take technical aspects of the laser equipment, stone consistency, and the surgeon's experience into consideration.

Investigation on radiofrequency and laser (980 nm) effects after endoluminal treatment of saphenous vein insufficiency in an ex-vivo model.

OBJECTIVES: An ex-vivo model for the experimental evaluation of endoluminal thermal procedures for occlusion of saphenous veins was developed. Radiofrequency obliteration (RFO) and endovenous laser therapy (ELT) were compared using this model. DESIGN: Experimental ex-vivo treatment study. MATERIALS AND METHODS: The model consists of the subcutaneous foot veins from freshly slaughtered cows which were reperfused in situ with heparinised bovine blood. The veins were treated with either radiofrequency (RFO n=5) or with endoluminal 980 nm laser light (ELT n=5) using a continuous pull-back for RFO and a stepwise illumination and pull-back protocol for ELT. Immediately after treatment perivenous tissue and veins were examined macroscopically. In a second study the same treatment parameters were used in four further vein segments with RFO (n=2) and ELT (n=2). These vein segments were examined microscopically in HE-stained histological sections. RESULTS: Induration of the vessel wall and contraction of the vessel lumen were observed after RFO. Laser treatment produced carbonised lesions of the vein wall. After 12-24 laser exposures these lesions often became transmural, causing complete perforation of the vessel wall. Histological evaluation after radiofrequency treatment demonstrated homogenous circular thermal tissue alteration with disintegration of intima and media structures. Histological evaluation after endovenous laser treatment showed large variations of thermal tissue effects. Tissue effects ranged from major tissue ablation and vessel wall disruption to minor effects located between laser exposures and on the opposite vessel wall. CONCLUSIONS: Our model is suitable for systematic scientific evaluation of endovenous thermal occlusion procedures. Our first results and theoretical considerations indicate that endovenous laser treatment should be modified in order to ensure controlled homogenous circular thermal damage, avoiding vessel wall perforation and damage to perivascular structures.

Image guided interstitial laser thermotherapy: a canine model evaluated by magnetic resonance imaging and quantitative autoradiography.

OBJECTIVE: To determine the applicability and safety of a new canine model suitable for correlative magnetic resonance imaging (MRI) studies and morphological/pathophysiological examination over time after interstitial laser thermotherapy (ILTT) in brain tissue. MATERIAL AND METHODS: A laser fibre (Diode Laser 830 nm) with an integrated temperature feedback system was inserted into the right frontal white matter in 18 dogs using frameless navigation technique. MRI thermometry (phase mapping i.e. chemical shift of the proton resonance frequency) during interstitial heating was compared to simultaneously recorded interstitial fiberoptic temperature readings on the border of the lesion. To study brain capillary function in response to ILTT over time quantitative autoradiography was performed investigating the unidirectional blood-to-tissue transport of carbon-14-labelled alpha amino-isobutyric acid (transfer constant K of AIB) 12, 36 hours, 7, 14 days, 4 weeks and 3 months after ILTT. RESULTS: All laser procedures were well tolerated, laser and temperature fibres could be adequately placed in the right frontal lobe in all animals. In 5 animals MRI-based temperature quantification correlated strongly to invasive temperature measurements. In the remaining animals the temperature fibre was located in the area of susceptibility artifacts, therefore, no temperature correlation was possible. The laser lesions consisted of a central area of calcified necrosis which was surrounded by an area of reactive brain tissue with increased permeability. Quantitative autoradiography indicated a thin and spherical blood brain barrier lesion. The magnitude of K of AIB increased from 12 hours to 14 days after ILTT and decreased thereafter. The mean value of K of AIB was 19 times (2 times) that of normal white matter (cortex), respectively. CONCLUSION: ILTT causes transient, highly localised areas of increased capillary permeability surrounding the laser lesion. Phase contrast imaging for MRI thermomonitoring can currently not be used for reliable temperature readings in vivo. The suggested new canine model proved to be safe, accurate, easy to use, and provides clinical, radiographic, pathological and physiological correlations.

[MRI-assisted thermometry for regional hyperthermia and interstitial laser thermotherapy]. / MRT-gestützte Thermometrie in der regionalen Tiefenhyperthermie und interstitiellen Laserthermotherapie.

PURPOSE: To demonstrate the potential of quantitative MRI-assisted thermometry for the treatment of tumor patients with regional hyperthermia (RHT) and interstitial laser thermotherapy (ILTT). METHODS: Two patients and seven tissue samples were investigated using the T1-relaxation time and the chemical shift of the proton resonance frequency (PRF) as temperature sensitive MRI-parameters at 0.2 and 1.5 T. Thermotherapy was applied using either a dedicated MRI-hyperthermia hybrid system or a temperature controlled laser with 830 nm. RESULTS: Both patients were treated successfully showing clinical benefit. T1 and PRF are depending on the applied thermotherapy method and on the MR-system suitable for MRI-assisted thermometry. The clinical application based on phantom results is not necessarily adequate. CONCLUSION: Clinical application and phantom experiments of RHT and ILTT show the potential of MRI-assisted thermometry for further improvement of both minimal invasive thermotherapy methods. Further investigations concerning optimization of the MRI-techniques, the influence of perfusion or the determination of threshold values are necessary.

[Ho:YAG and diode laser treatment of hyperplastic inferior nasal turbinates]. / Die Laserkonchotomie mit Ho:YAG- und Dioden-Laser zur Behandlung von hyperplastischen Nasenmuscheln.

BACKGROUND: Since the early 80's, chronic nasal obstruction due to hyperplastic turbinates is treated by laser light. Comparative clinical studies were performed to assess the clinical outcome of laser assisted endonasal turbinate surgery in longterm. METHODS: By means of a pulsed Ho:YAG laser emitting light at lambda = 2100 nm (0.8 - 1.2 J/pulse, 4 - 8 Hz), 69 patients suffering from nasal obstruction due to allergic rhinitis (46 %) and vasomotor rhinitis (54 %) were treated under local anesthesia. Furthermore, 50 patients (52 % with allergic rhinitis and 48 % with vasomotor rhinitis) were treated by means of a GaAlAs-diode laser (c. w., lambda = 940 nm, 8 - 10 W). The treatment time took 3 - 10 min/turbinate and nasal packing was not necessary after the laser procedure. The study was conducted by a standardized questionnaire, photo documentation, allergy test, mucociliar function test, rhinomanometry, and acoustic rhinometry. RESULTS: Within 4 weeks after laser treatment, an improvement of nasal airflow correlating to the extent of the ablated turbinate tissue could be determined in more than 80 % of the patients. Rhinomanometry revealed a significant improvement of the nasal airflow 6 months and 1 year after the laser treatment compared to the preoperative data. Side effects like nasal dryness and pain were rare (< 5 %). Diode laser treatment revealed more effective results than Ho:YAG laser treatment, however there was no significant difference between the two investigated groups. Patients suffering from vasomotor rhinitis showed far better results in long term in comparison to allergic rhinitis patients. CONCLUSIONS: Ho:YAG and diode laser treatment can be performed as an outpatient procedure under local anesthesia in a short treatment time with promising results. It could become a time and cost effective treatment modality in endonasal laser surgery.

[Brain protective interstitial laser thermotherapy. Therapy of brain tumors without secondary damage]. / Gehirn schonende interstitielle Laserthermotherapie. Therapie von Hirntumoren ohne Umgebungsschäden.

The purpose of interstitial radiosurgery is to deliver a necrotizing dose of heat to an accurately defined focal area without damaging adjacent healthy brain tissue. To achieve this, heat at a temperature of 60-100 degrees C is applied via a laser fiber placed stereotactically in the center of the tumor. With the aid of thermosensitive magnetic resonance imaging (MRI), not only can the heat distribution within and around the tumor be measured during treatment, but also the extent of the lesion produced assessed. Interstitial laser thermotherapy (ILTT) performed under MRI monitoring, could become an important interdisciplinary minimally invasive treatment option for patients with brain tumors. Experimental data on the biological effects of interstitial laser therapy on normal brain tissue are not yet available, and only preliminary clinical studies investigating the effects of laser energy on brain tumors have so far been carried out. This overview presents a description of our own initial results, discusses the present state of our knowledge and current possibilities and limitations of this new treatment modality.

Laser treatment of hyperplastic inferior nasal turbinates: a review.

BACKGROUND AND OBJECTIVE: Since the early 80s various types of lasers have been used for the reduction of hyperplastic inferior nasal turbinates. Up to now many studies have revealed a variety of important information. To summarize these findings and to determine the value of laser treatment of hyperplastic inferior nasal turbinates, a comparative review of the literature was performed. STUDY DESIGN/MATERIALS AND METHODS: The study of the literature revealed that hyperplastic inferior turbinates of more than 2,000 patients have been treated and followed up. Treatment was performed with the CO2 (10,600 nm), diode (805/810/940 nm), Argon-ion (488/514 nm), KTP (532 nm), Nd:YAG (1,064 nm), and Ho:YAG (2,080 nm) laser in more than 20 studies so far. Generally, the authors of the trials used different laser parameters (power, energy) and application modalities (contact, non-contact, interstitial, superficial). To determine the long-term results objective (active anterior rhinomanometry, acoustic rhinometry, mucociliary function tests, allergy tests) as well as subjective parameters (questionnaire) were recorded and evaluated. In some cases morphological changes of the turbinate tissue were studied by light and scanning electron microscopy (SEM). RESULTS: Laser surgery of inferior turbinates can be performed as an outpatient procedure under local anesthesia. Due to a minimally invasive and controllable coagulation and ablation of soft tissue, almost no complications or bleedings were observed during the operation or postoperatively. Depending on the chosen parameters (power, energy) and the application modalities (contact, non-contact, superficial, interstitial) laser treatment of hyperplastic inferior nasal turbinates achieved comparable or better results than most of the conventional techniques for turbinate surgery like conchotomy, electrocautery, cryotherapy, chemical cauterization, and vidian neurectomy. More invasive (radical) operative methods, such as inferior turbinoplasty, submucous turbinectomy, lateral outfracture, partial and total turbinectomy, seemed to be more effective than laser surgery in the long-term. CONCLUSIONS: Laser treatment of hyperplastic inferior nasal turbinates can be considered as a useful, cost-effective, and time-saving procedure for the reduction of hyperplastic inferior nasal turbinates. Short operation time, good results, and minor side effects compared to other surgical methods provide an excellent clinical response of the patients.

Diode laser treatment of hyperplastic inferior nasal turbinates.

UNLABELLED: Background and Objective Different laser types have been used for the treatment of hyperplastic inferior nasal turbinates. The clinical experiences of its treatment by means of a diode laser are presented. Study Design/Materials and Methods A total of 76 patients suffering from nasal obstruction due to hyperplastic inferior nasal turbinates were treated with a continuous diode laser (wavelength of lambda = 940 nm, laser parameter 10 W/energy/turbinate 5 kJ) in "noncontact" mode and under local anesthesia. All patients were refractory to conservative medical treatment. Fifty patients (26 of 50 [52%] with allergic rhinitis and 24 of 50 [48%] with vasomotor rhinitis) were included into this clinical trial with a follow-up of 1 year. The study was conducted by a questionnaire, photo documentation, allergy test, mucociliary clearance test, rhinomanometry, acoustic rhinometry, conventional radiology of the paranasal sinuses, and histology. RESULTS: The mean operation time took 6 min/turbinate, no nasal packing was necessary and no immediate complications (e.g., major bleeding) were observed. During the first 2-4 weeks, nasal obstruction was correlated to the extent of postoperative edema and nasal crusting. Statistical analysis revealed significant improvement of the nasal airflow (rhinomanometry) and nasal cavity volume (acoustic rhinometry) 6 months and 1 year after laser surgery, respectively. A total of 86% of the patients described a subjective improvement of nasal airflow 6 months and 76% of the patients 1 year after laser treatment. The mucociliary function test showed no significant variation in comparison to the preoperative measurements 1 year after laser treatment. CONCLUSION: Diode laser treatment of hyperplastic inferior nasal turbinates is a useful procedure, which can be performed as an outpatient surgery under local anesthesia, resulting in a controlled coagulation and ablation of the soft tissue. The short operation time and the good results provide an excellent patient acceptance.

Effects of 780 nm diode laser irradiation on blood microcirculation: preliminary findings on time-dependent T1-weighted contrast-enhanced magnetic resonance imaging (MRI).

Laser therapy by low light doses shows promising results in the modulation of some cell functions. Various clinical studies indicate that laser therapy is a valuable method for pain treatment and the acceleration of wound healing. However, the mechanism behind it is still not completely understood. To explore the effect of a low-power diode laser (lambda = 780 nm) on normal skin tissue, time-dependent contrast enhancement has been determined by magnetic resonance imaging (MRI). In the examinations, six healthy volunteers (four male and two female) have been irradiated on their right planta pedis (sole of foot) with 5 J/cm2 at a fluence rate of 100 mW/cm2. T1-weighted magnetic resonance imaging is used to quantify the time-dependent local accumulation of Gadolinium-DPTA, its actual content in the local current blood volume as well as its distribution to the extracellular space. Images are obtained before and after the application of laser light. When laser light is applied the signal to noise ratio increases by more than 0.35 +/- 0.15 (range 0.23-0.63) after irradiation according to contrast-enhanced MRI. It can be observed that, after biomodulation with light of low energy and low power, wound healing improves and pain is reduced. This effect might be explained by an increased blood flow in this area. Therefore, the use of this kind of laser treatment might improve the outcome of other therapeutic modalities such as tumour ionizing radiation therapy and local chemotherapy.

Magnetic resonance imaging (MRI) controlled outcome of side effects caused by ionizing radiation, treated with 780 nm-diode laser -- preliminary results.

BACKGROUND AND OBJECTIVE: Ionizing radiation therapy by way of various beams such as electron, photon and neutron is an established method in tumor treatment. The side effects caused by this treatment such as ulcer, painful mastitis and delay of wound healing are well known, too. Biomodulation by low level laser therapy (LLLT) has become popular as a therapeutic modality for the acceleration of wound healing and the treatment of inflammation. Evidence for this kind of application, however, is not fully understood yet. This study intends to demonstrate the response of biomodulative laser treatment on the side effects caused by ionizing radiation by means of magnetic resonance imaging (MRI). STUDY DESIGN/PATIENTS AND METHODS: Six female patients suffering from painful mastitis after breast ionizing irradiation and one man suffering from radiogenic ulcer were treated with lambda=780 nm diode laser irradiation at a fluence rate of 5 J/cm2. LLLT was performed for a period of 4-6 weeks (mean sessions: 25 per patient, range 19-35). The tissue response was determined by means of MRI after laser treatment in comparison to MRI prior to the beginning of the LLLT. RESULTS: All patients showed complete clinical remission. The time-dependent contrast enhancement curve obtained by the evaluation of MR images demonstrated a significant decrease of enhancement features typical for inflammation in the affected area. CONCLUSION: Biomodulation by LLLT seems to be a promising treatment modality for side effects induced by ionizing radiation.

Photodynamic destruction of high grade dysplasia and early carcinoma of the esophagus after the oral administration of 5-aminolevulinic acid.

BACKGROUND: Photodynamic therapy (PDT) is a new local, endoscopically controlled therapeutic concept based on the selective sensitization of malignant and precancerous lesions prior to light-induced tissue destruction. 5-aminolevulinic acid (5-ALA) appears to be a promising alternative photosensitizer with a high mucosa specificity without phototoxic side effects on the skin. The authors report on their experiences with this new form of PDT in 27 patients. METHODS: Twenty-seven patients (6 females and 21 males; ages 47-79 years) with histologically proven high grade dysplasia (n = 9) and early carcinoma (normal endoultrasonography or classified as uT1N0M0; n = 19; 1 patient had 2 lesions) of the esophagus were included in this study. Approximately 4-6 hours after oral ingestion of 5-ALA in a dosage of 60 mg/kg of body weight, laser light irradiation was conducted with a dye laser system with a wavelength of 635 nanometers at a light dose of 150 J/cm(2). RESULTS: The length of the segment of the esophagus with severe dysplasia or carcinoma of the mucosa varied between 0.5-9.0 cm (mean length, 2.5 cm). High grade dysplasia was eradicated in all patients. In addition, 19 mucosal tumors in 18 patients were treated successfully in 10 of 19 cases with an average of 1.7 treatment sessions and a mean follow-up of 16.9 months (range, 3-37 months). Method-related morbidity and mortality were not observed. CONCLUSIONS: Severe dysplasia and superficial (

Ho:YAG laser treatment of hyperplastic inferior nasal turbinates.

OBJECTIVES: Although preliminary studies about the successful use of the Ho:YAG laser in nasal turbinate surgery have been reported, no clinical study has been performed on this procedure. The aim of this prospective clinical study was to assess the long-term effect of Ho:YAG laser in the treatment of hyperplastic inferior nasal turbinates. METHODS: Eighty-five patients with nasal obstruction who did not respond to conservative medical treatment were treated with a pulsed Ho:YAG laser (wavelength of =2080 nm). Fifty-two of these patients were included in this clinical study and were followed for 1 year. RESULTS: Within the first 2 weeks, nasal obstruction was correlated to the extent of nasal crusting. Six months after laser treatment, the mucociliary function test showed no variation compared with the preoperative measurements. One year after laser treatment 77% of the patients demonstrated improved nasal airflow on rhinomanometry and questionnaire. CONCLUSIONS: Ho:YAG-laser treatment of hyperplastic turbinates can be performed as outpatient surgery under local anesthesia and offers controllable ablation of soft tissue in a short operation time with satisfactory results and excellent patient acceptance.