Role of CO2 Laser in the Management of Symptomatic Hypertrophy of Inferior Nasal Turbinates.

The aim of this study was to evaluate the efficacy of CO2 laser ablation in the management of symptomatic hypertrophied inferior nasal turbinates. This prospective observational study was carried out on 53 patients with symptomatic ITH refractory to medical management in the Department of Otorhinolaryngology and Head and Neck Surgery, SMHS Hospital, Srinagar, J&K from January 2017 to June 2018 after obtaining ethical clearance. The pre and postoperative subjective assessment of the nasal obstruction included nasal obstruction symptom evaluation scale (NOSE) and the visual analogue scale (VAS). Lund and Kennedy endoscopic scoring was used to assess postoperative intranasal crusting and tissue healing. Postoperative pain was evaluated using VAS. All patients underwent CO2 laser spot ablation of hypertrophic inferior turbinates under local anesthesia in an outpatient setting. The patients were followed up at 2 weeks, 1 month and 3 months postoperatively. The VAS score for nasal obstruction improved from preop score of 6.05 (± 2.1) to 3.0 (± 1.01), 2.01 (± 0.90), 1.18 (± 0.40) at 2 weeks, 1 month and 3 months respectively in the postop period and the NOSE score also improved from preop score of 64.90 (± 13.29) to post-operative NOSE score of 18.96 (± 9.53) at 2 weeks, 9.81 (± 7.33) at 1 month and 5.09 (± 4.28) at 3 months. Difference between preoperative and postoperative NOSE and VAS scores was statistically significant (p < 0.05). There was minimal postoperative pain and intranasal crusting. Postoperative tissue healing was also good. CO2 laser turbinoplasty is a safe and effective way of improving nasal flow. It offers more precision, gentleness, control and less intraoperative discomfort. CO2 laser turbinoplasty meets all of the criteria for an ideal method for the treatment of nasal obstruction secondary to inferior turbinate hypertrophy with improvement of quality of life and reducing the risk of medical morbidity.