Wound healing in the nose and paranasal sinuses after irradiation with the argon laser

Abstract

The wound healing of the mucous membrane of the nose was investigated in rabbits after irradiation with the argon laser. Immediately after application of the laser, a typical lesion showed a zonal appearance. Wound healing began after a delay of 6 days with the formation of granulation tissue. Re-epithelialization began from the margins of the wound and was characterized initially by metaplastic epithelium or squamous epithelium that was subsequently replaced by respiratory epithelium. In the subepithelial tissue plane, particularly following irradiation of the concha, a wider layer of connective tissue developed. The hyaline cartilage of the septum became necrotic over a large area which extended beyond the irradiated area, while the bone of the concha and the wall of the maxillary sinus was destroyed only at the site of the direct laser treatment.

Wound Healing in the Rabbit Paranasal Sinuses after Coblation: Evaluation for use in Endoscopic Sinus Surgery

“…7 With an argon laser, there was necrosis of bone, a wide area of mucosal injury with progressive loss of layering of epithelium closer to the wound, and an intense purulent inflammatory reaction. 7,8 Unlike other thermal instruments that penetrate bone easily, in the current study, bone in the zone of Coblation injury showed reparative changes but no necrosis or infection. Coblation can, however, remove bone as shown by gross evaluation of one maxillary sinus wall in the current study.…”

“…In the current study, Coblation injury was consistent with thermal injury, and the mucosa responded appropriately, based on previous literature. [6][7][8][9][10] Typically, with mechanical injury, damaged cells immediately release cytokines and polymorphonuclear neutrophils migrate within the first 24-48 hours. 9 Neutrophils are then replaced by monocytes, macrophages, and lymphocytes 3-5 days after injury.…”

3 Laser in der Rhinologie

“…Die Wundheilung dauert je nach Ausmaû der überschüssigen Gewebevernichtung 3 ± 6 Wochen. Die laserinduzierte subepitheliale Fibrose ist erst nach einem Jahr vollständig abgeschlossen [21,22]. Über 80 % der Patienten zeigten nach Argon-Laser-Strichkarbonisation eine Verbesserung der Nasenatmung.…”

“…Das Nd:YAG-Laserlicht verursacht in der Schleimhaut eine ausgeprägte Fibrosierung mit Atrophie der Schleimdrüsen und Verkleinerung des venösen Plexus [15,21,22]. Aufgrund der groûen Eindringtiefe der Nd:YAG-Laserstrahlung sind diese Veränderungen am Gewebe stärker ausgeprägt als beim Argon-bzw.…”

Holmium

“…Selective absorption by blood results in the coagulation of vessels with sparing of the surrounding avascular tissue. The argon laser can seal vessels up to 1 mm in diameter 53 …”