Histopathologic Study of Allergic Rhinitis Treated with Contact ND: YAG Laser Surgery

Min, Gyeong Min; Kim, Hae Song; Park, Eun Ho; Hong, Sung Bum; Park, Gun

Abstract

BACKGROUND: Many kinds of method have been tried for the management of allergic rhinitis. However, there is no completely satisfactory modality of treatment. Recent studys are reporting that laser vaporization on the inferior turbinate for the treatment of allergic rhinitis may be a valuable surgical method with safety, less morbidity and good efficasy. But, long term effects are unkown as yet.
OBJECTIVES
We aimed to observe histopathologic changes of nasal mucosal membrane about 2 years after laser surgery and to investigate relationships between improvement in subjective symptoms, frequency of surgery, and histopathologic findings.
MATERIALS AND METHODS
The inferior turbinates of 24 patients with perennial allergic rhinitis were vaporized by Contact ND: YAG laser. About 2 years after surgery, specimens obtained from the inferior turbinate were examined under the light microscopy.
RESULTS
1. Common findings of histopathologic change in all cases: 1) Fibrous proliferation and scar formation in the superficial layer of the submucosa. 2) Decreased number and atrophy of goblet cells, glands and vessels. 3) Complete regeneration of ciliated pseudostratified columnar epithelium. 2. Generally, grade of fibrosis in the submucosal superficial layer tend to increase as the frequency of surgery increase. but there is no relation, statistically. The higher grade of fibrosis do not induce the better subjective improvement. 3. Significant subjective improvement(Good and excellent results) was 75%.
CONCLUSION
These results suggest that allergic symptoms may be inhibited by fibrous scar formation of the submucosal superficial layer and by decreased number and atrophy of overproliferation of cells leading to allergic reaction. In addition laser surgery may be a safe and effective method with good regeneration of ciliated epithelium and high rate of improvement for treatment of allergic rhinitis. However, further study is necessary to proper explanation for result that grade of fibrosis have not a relation with subjective improvement and for long term effect of the laser surgery.