[Laser surgery of the middle nasal meatus in recurrent sinusitis]

We present our concept for treating patients suffering from recurrent sinusitis with coagulating lasers (Nd:YAG 1024 nm, Diode 810 or 904 nm). In these patients, the middle meatus is often narrowed by a hyperplastic middle turbinate, septum spurs and ridges, or by isolated polyps that block an ostium. We treat these patients by linear or punctate coagulation of the lateral wall of the middle turbinate, reducing the size of septum spurs, and blunting septal ridges or coagulating polyps. The outpatient procedure is performed with a laser fiberoptic system of 400 nm in contact mode with an energy of 3-5 watts. The amount of total energy applied to a specific tissue depends on the duration of laser contact at that point. The patient is anaesthesized superficially. Patients with a high degree of nasal hyperreactivity also receive antihistaminic preoperative treatment. Initial results show a significant increase of nasal flow with a decrease of sinus symptoms.