Laser Surgery for Perennial Nasal Allergy. 3rd Report; Its Mechanism. : -3rd Report; Its Mechanism-

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The long-term effects of CO2 laser surgery for nasal allergy were described previously. The mechanism was then investigated by antigen provocation tests. Rhinomanometry and laser doppler velocimetry were performed during provocation tests before and two months after surgery. The ECP (eosinophil cationic protein) content of the nasal lavage fluid was also measured. The amount of ECP was significantly decreased after surgery in each patient, especially in those with a very good response to surgery. Nasal airway resistance was not altered by the surgery; however, its response to antigen provocation was significantly lessened. Nasal blood flow in patients with nasal allergy was less than that in normal subject, but the difference was decreased by laser treatment. These result suggest that laser surgery is effective for nasal allergy via the following mechanism: laser injure vaporizes the nasal mucosa to a limited depth producing secondarily a permanent scared layer. This scar persists for as long as 5 years, preventing allergic reactions and inhibiting the release of chemical mediators. The elimination of superficial capillaries and surrounding connective tissue prevents mucosal edema. This surgery affects the resistant vessel layer and not the capacitant vessel layer. Therefore laser surgery seems to be functional and minimum surgery for nasal allergy.