Laser-assisted outpatient septoplasty and laser-assisted uvulopalatoplasty for nasal obstruction and snoring.

Abstract

OBJECTIVE: Nasal obstruction always occurs when the nasal passages are narrowed by a hypertrophic turbinate or a deviated nasal septum. Patients with nasal obstruction often have associated snoring. Laser-assisted outpatient septoplasty (LAOS) has a specific clinical application in chronic nasal obstruction due to moderate anterior septal deviation. Significant improvement has been reported in the measures of nasal obstruction following LAOS. The purpose of the present study was to evaluate the safety and efficacy of LAOS as an adjunctive procedure for snoring resulting from nasal obstruction. MATERIAL AND METHOD: Thirty-five patients with septal deviation and bothersome snoring were enrolled. Patients underwent a polysomnography study to rule out significant obstructive sleep apnea. Ablation of the nasal septum was undertaken with a carbon dioxide laser. No nasal packing was required. LAOS procedures were performed in conjunction with other snoring procedures (laser-assisted uvulopalatoplasty or laser turbinectomy) on an outpatient basis under local anesthesia. Data on the patients were compared from the preoperative to the postoperative assessment. Statistics used were determined by the Student's paired t test. RESULTS: All patients tolerated the procedure well. The additional surgical time needed to perform this procedure averaged 10 minutes. The mean nasal obstruction scale improved from 6.2 + 3.2 to 1.6 + 0.8 (p < 0.01) and the mean total nasal resistance decreased significantly after operation. Significant improvement was observed in the snoring scale (8.8 + 2.2 vs 2.8 + 1.7, p < 0. 05). No significant complications were noted. There were 2 cases of minor bleeding, which were easily treated. Postoperative pain was rated as minimal (VAS < 4). Follow-up of 4 to 6 months showed overall improvement of nasal obstruction and snoring symptoms in more than 90% of the patients. CONCLUSION: LAOS is a simple and well-tolerated treatment for deviated nasal septum. It appears to be a safe and effective adjunct surgical procedure for snorer with nasal obstruction on an outpatient basis.