Comparison of efficacy of potassium titanyl phosphate laser & diode laser in the management of inferior turbinate hypertrophy: A randomized controlled trial

Abstract

Background & objectives: Inferior turbinate hypertrophy (ITH) is a common condition causing nasal obstruction. This study was undertaken to compare the efficacy of potassium titanyl phosphate (KTP) laser and diode laser in the reduction of the turbinate size. Methods: This randomized controlled trial included 209 patients with ITH. Pre-operative symptoms were assessed based on the Nasal Obstruction Symptom Evaluation (NOSE) score. Diagnostic nasal endoscopy was done to rule out other nasal sinuses. Nasal mucociliary clearance was measured by saccharin transit time (STT). Postoperatively, the NOSE score, STT and complications were assessed at days one and two, at one week, one month and three months. Results: Of the 209 patients analyzed at day one, the median NOSE score was 50 in the diode group and 40 in the KTP group, and at three months, 15 in the diode group and five in the KTP group. KTP laser showed a 93 per cent improvement in the NOSE score as compared to 77 per cent improvement shown by diode laser group. Among the intra-operative complications, of the 104 patients in the diode group, 6.73 per cent had burning sensation and 91.43 per cent had bleeding, and of 105 patients in the KTP group, 54.29 per cent had burning sensation and 36.54 per cent had bleeding. Among the post-operative complications in the KTP group, 32 and 34 per cent had bloody nasal discharge on days one and two, compared to 12 and 14 per cent in diode group. Crusting was present in 61 and 49 per cent on days one and two in KTP group as compared to 9 and 15 per cent in diode group, respectively. In the KTP group 30 per cent had synechiae as compared to 10 per cent in diode group. Interpretation & conclusions: KTP laser was more efficacious than diode laser in improving the NOSE scores but with slightly increased rate of complications in early post-operative period. Both the lasers impaired the mucociliary clearance mechanism of the nose till three months of post-operative follow up.

Therapeutic Efficacy of Diode Laser Turbinoplasty on Nasal Obstruction Estimated with Rhinomanometry

“…Diode laser-assisted turbinate surgery is a popular procedure for improving nasal airflow. It is better absorbed by tissue than that of Nd: YAG lasers but with tissue ablation effects similar to a carbon dioxide laser [1]. Volk et al [4] evaluated diode laser-assisted nasal airflow and reported that rhinomanometry with decongestion has a predictive value for the enhancement of airflow after surgery.…”

“…Diode-assisted laser turbinoplasty is a widely used surgical method for improving airflow as a treatment for nasal obstruction [1]. Predominantly caused by hypertrophy of the inferior nasal turbinates, nasal obstruction remains one of the most common conditions encountered in rhinology practice.…”

Surgical Treatment for the Refractory Allergic Rhinitis: State of the Art

“…On the other hand, both lasers altered the nose's mucociliary clearance for up to three months of postoperative follow-up. KTP laser was more productive than diode laser in improving the NOSE scores but with a slightly increased rate of complications in the early postoperative period [72].…”

“…Another recent study compared the KTP laser with the diode laser [72]. This randomized controlled trial included 209 patients with ITH.…”