A pilot study into the effect of low-level laser therapy in patients with chronic rhinosinusitis.
Assistant Professor, Department of Physiotherapy, School of Rehabilitation , Tehran University of Medical Sciences , Tehran , Iran.
Chronic rhinosinusitis (CRS) is a common inflammatory disease of the nose and paranasal sinuses that has a significant impact on patients’ quality of life. No study has examined the effectiveness of applying low-level laser therapy (LLLT) locally over the sinuses in patients with CRS. The aim of this study was to evaluate the effect of LLLT in patients with CRS. Fifteen adult patients with CRS participated in this pilot pretest-posttest clinical study. Patients were treated with a 830-nm Ga-Al-As laser in continuous-wave mode at a power output of 30 mW and energy dose of 1 J. Laser irradiation was delivered on six points over each maxillary or frontal sinus with 33 sec irradiation for each point and a total treatment duration of 198 sec for each sinus. Patients were given LLLT three times per week for ten treatment sessions. Patients were asked to score their symptoms in accordance with a four-point scale (0-3), and a total symptom score (TSS) for each patient was calculated. Percentage improvement of TSS was considered as the primary outcome measure. TSS was calculated at baseline (T0), at 2 weeks (T1) and at 4 weeks (T2). The TSS was improved significantly at T1 (39%) and at T2 (46.34%). A large effect size for LLLT was found (np2np2 = 0.63). The therapeutic effect was sustained for a mean of 5 months. This pilot study indicates that LLLT applied for 4 weeks improves symptoms in patients with CRS.
Am J Rhinol Allergy. 2009 Sep-Oct;23(5):527-30.
KTP/532 YAG laser treatment for allergic rhinitis.
Yaniv E, Hadar T, Shvero J, Tamir R, Nageris B.
Nose and Sinus Institute, Department of Otorhinolaryngology, Rabin Medical Center, Beilinson Campus, Petah Tiqwa and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. firstname.lastname@example.org
BACKGROUND: The purpose of this study was to investigate the efficacy of the KTP/532 YAG laser to reduce nasal congestion and discharge in patients with allergic rhinitis.
METHODS: Forty-eight patients with symptoms of allergic rhinitis were treated with the KTP/532 laser. All had positive skin tests for common allergens. Treatments were provided on an ambulatory basis in one to three sessions under local anesthesia with lidocaine nose spray. Outcome was determined by daily symptom reports and regular endoscopy examination and interviews for 12 months.
RESULTS: Treatment was very well tolerated. There were no major side effects. At examination after 1 year, nasal obstruction was improved in 69% and nasal discharge in 40% of cases.
CONCLUSION: The KTP/532 YAG laser is effective for the treatment of nasal obstruction and discharge. Comparison with other techniques showed it to be the most effective in reducing nasal discharge. It can be done as an office procedure and does not damage the nasal mucous membrane. The KTP/532 YAG laser is effective as an additional treatment for patients refractory to medication.
Rhinophototherapy: a new therapeutic tool for the management of allergic rhinitis.
Department of Dermatology and Allergology, University of Szeged, Hungary. email@example.com
Phototherapy has a profound immunosuppressive effect and is able to inhibit hypersensibility reactions in the skin.
We evaluated whether phototherapy using a combination of UV-B (5%), UV-A (25%), and visible light (70%), referred to as mUV/VIS, is effective in treating allergic rhinitis.
We conducted a randomized, double-blind study, in 49 patients with hay fever. The study was performed during the ragweed season. Each intranasal cavity was illuminated 3 times a week for 3 weeks with mUV/VIS or with low-intensity visible light. Symptom scores, inflammatory cells, and their mediators were assessed in nasal lavages. In vitro effects of mUV/VIS irradiation on T-cell and eosinophil apoptosis and its inhibitory effect on mediator release from basophils were examined.
Rhinophototherapy was tolerated well and resulted in a significant improvement of clinical symptoms for sneezing (P < .016), rhinorrhea (P < .007), nasal itching (P < .014), and total nasal score (P < .004). None of the scores improved significantly in the control group. Scores for nasal obstruction slightly improved after mUV/VIS treatment and significantly increased in the control group (P < .017). In the nasal lavage, phototherapy significantly reduced the number of eosinophils and the level of eosinophil cationic protein and IL-5. In vitro irradiation of T cells and eosinophils with mUV/VIS light dose-dependently induced apoptosis. Furthermore, mUV/VIS irradiation inhibited the mediator release from RBL-2H3 basophils.
These results suggest that phototherapy is an effective modality to treat allergic rhinitis and offer new options for the treatment of immune-mediated mucosal diseases.
Ter Arkh. 2004;76(3):20-3.
Efficacy of noninvasive hemolaserotherapy in patients with bronchial asthma and concomitant rhinosinusitis.
[Article in Russian]
Nikitin AV, Treshchalina IuB.
AIM: To study efficacy of low-intensive infrared laser radiation impact on the tympanic membrane in patients with bronchial asthma (BA) and concomitant rhinosinusitis (RS).
MATERIAL AND METHODS: 78 patients with moderate BA of a mixed type and concomitant chronic RS were divided into 3 groups: group 1 patients received medication plus infrared laser radiation of the tympanic membrane and paranasal sinuses; group 2 patients were exposed to supravenous laser radiation (0.63 mcm); group 3 received pharmacotherapy alone. The effect of the treatment was assessed by spirometry, peakflowmetry and paranasal sinuses findings.
RESULTS: The highest response was achieved in group 1 which manifested with positive changes in clinical, device and spirometric data on BA and x-ray data on RS courses. The least effective treatment was observed in group 3.
CONCLUSION: Use of infrared laser radiation of the tympanic membrane and paranasal sinuses projection in the treatment of BA patients with RS is effective, nontoxic and easy to use both in hospitals and outpatient departments.
J Photochem Photobiol B. 2004 Sep 8;75(3):137-44.
Intranasal irradiation with the xenon chloride ultraviolet B laser improves allergic rhinitis.
Csoma Z, Ignacz F, Bor Z, Szabo G, Bodai L, Dobozy A, Kemeny L.
Department of Dermatology and Allergology, University of Szeged, P.O. Box 427, H-6701 Szeged, Hungary.
We earlier reported that the 308 nm xenon chloride (XeCl) ultraviolet B (UVB) laser is highly effective for the treatment of inflammatory skin diseases. Since UVB irradiation has been shown to exert both local and systemic immunosuppression, we investigated the clinical efficacy of UVB irradiation in allergic rhinitis. In an open study, groups of patients with severe allergic rhinitis received intranasal irradiation with a 308 nm XeCl UVB excimer laser for two weeks. In the low-dose group (n=10), treatment was given twice weekly, starting with 0.25x the individual minimal erythema dose (MED), whereas patients in the medium-dose group (n=8) were treated four times weekly, starting with 0.4x MED. In each group, the dosage was gradually increased. Evaluation was based on the symptom scores. The effect of the XeCl laser on the skin prick test reaction was also studied. In the low-dose group, seven patients completed the study, and there was no improvement in the nasal symptoms. In the medium-dose group, the XeCl UVB irradiation significantly inhibited the rhinorrhoea, the sneezing, the nasal obstruction and the total nasal score (p<0.05). The XeCl UVB excimer laser also inhibited the allergen-induced skin prick test in a dose-dependent manner. These results suggest that the XeCl UVB excimer laser might serve as a new therapeutic tool in the treatment of allergic rhinitis.
Narrow-band red light phototherapy in perennial allergic rhinitis and nasal polyposis.
Department of Allergy and Asthma, Hasharon Hospital, Petah Tiqwa, Israel.
Allergic rhinitis and nasal polyposis are common nasal diseases, but the available treatment modalities have only limited success.
To assess the therapeutic effect of low-energy narrow-band red light phototherapy on nasal clinical symptoms of allergic rhinitis and nasal polyposis.
In a double-blind randomized prospective study, 50 patients with allergic rhinitis and 10 with nasal polyposis received intranasal illumination at 660 nm for 4.4 minutes three times a day for 14 days (total dose 6 joules per day). Twenty-nine rhinitic patients and one patient with polyposis received equivalent sham illumination as placebo. Evaluation was based on symptom scores and a clinical assessment that included pre-treatment and post-treatment videotaped rigid and flexible nasendoscopy.
Following treatment, improvement of symptoms was reported by 72% of the allergic rhinitis patients and objective improvement was endoscopically demonstrated in 70% of them as compared with 24% and 3%, respectively, in the placebo group. These differences were significant. No improvement was obtained in any of the patients with polyposis.
Allergic rhinitis, if uncomplicated by polyps or chronic sinusitis, can be effectively treated by narrow-band red light illumination of the nasal mucosa at 660 nm, with marked alleviation of clinical symptoms. Whenever possible, candidates for phototherapy should be selected by endoscopic examination.
|Vestn Otorinolaringol. 1990 Sep-Oct;(5):21-7.|
Functional methods of study in the evaluation of the effectiveness of laser therapy of vasomotor rhinitis and some forms of prosopalgia.
[Article in Russian]
Shuster MA, Isaev VM, Kaevitser IM.
Highly sensitive instrumental methods such as rhinopneumography, rhinorheography, rheoencephalography and segmented sphygmography were used to measure the efficacy of contact laser therapy of the pterygopalatine ganglion to treat vasomotor rhinitis and trigeminal neuralgia. This method proved efficient in the case of the nervous form of vasomotor rhinitis, Sluder syndrome, and trigeminal neuralgia. Stable remission developed in 60% of patients.
|Vestn Otorinolaringol. 1991 May-Jun;(3):60-3.|
Clinical effectiveness of magnetolaser therapy of vasomotor rhinitis
[Article in Russian]
Magnet-laser therapy was used to treat vasomotor rhinitis in 90 patients. A constant magnet of 50 mT was applied to the exterior of the nose, and an infrared laser beam was applied via a light-guide to the reflexogenic zones of concha inferior. The radiation power density was 5 mW/cm2. The magnetic exposure time was 6-10 min and the laser exposure time was 3-5 min for each half of the nose. The therapeutic course was 8-12 sessions. The therapeutic results depended on the type of vasomotor rhinitis, clinical disorders, and duration of the disease. Good results were seen in 84 (93.3%) patients out of 90 cases. Stable remission was recorded in 61.1% patients, significant improvement of clinical manifestations of vasomotor rhinitis was observed in 32.2% cases. Best results were reported in patients with autonomic forms of vasomotor rhinitis who suffered from short-term disease and vasodilation disorders.