鼻アレルギーのレーザー手術に関する研究

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  • Laser Surgery for Allergic Rhinitis

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Laser surgery, which is one type of surgical treatment for allergic rhinitis, was investigated basically and clinically.<BR>Basically, we observed morphologic changes in nasal mucosa before and after laser surgery using an optical microscope and scanning electron microscope. The following results were obtained:<BR>1) Hyperplasia of the mucous epithelium, thicking of the basement membrane, edema of the lamina propria mucosae, eosinophilic infiltration, enlargement of the nasal glands and dilatation of the sinusoidal capillary were noted in the allergic nasal mucosa before laser surgery.<BR>2) After laser surgery, the nasal mucosa was covered with epithelium that was squamatized or cuboidal and/or columnar epithelium that was stratified. Granulation-like tissue or cicatricial tissue was found, but edema, eosinophilic infiltration and enlarged nasal glands all but disappeared in the lamina propria mucosae.<BR>Between Jun e 1986 and November 1993, laser surgery was performed clinically for 204 cases of refractory, perenial allergic rhinitis at the Out-patient Clinic, Department of Otolaryngology, National Defense Medical College Hospital. The following results were obtained:<BR>1) Regarding short-term results (4 to 10 weeks after surgery), Laser su rgery was effective in 70%(83 of 119 cases) for sneezing,72% (120 of 166 cases) for nasal discharge,91% (185 of 204 cases) for nasal obstruction and 87% (177 of 204 cases) for nasal symptoms overall.<BR>2) Regarding long-term results (more than 2 years after surgery), the short-term results had persisted in 81% (26 of 32 cases) for sneezing,78% (32 of 41 cases) for nasal discharge,76% (38 of 50cases) for nasal obstruction.<BR>From these r e sults, we conclude that laser surgery was a useful surgical treatment for allergic rhinitis.

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