Laser-assisted Outpatient Septoplasty and Laser-assisted Uvulopalatoplasty for Nasal Obstruction and Snoring
Chairat Neruntarat, MD*
Affiliation : * Department of Otolaryngology, Faculty of Medicine, Srinakharinwirot University, HRH Princess Maha Chakri Sirindhorn Medical Center, Nakhon Nayok
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.
Materials and Methods : 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 Studentís 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.
Keywords : Laser, Outpatient, Septoplasty, Uvulopalatoplasty, Nasal obstruction, Snoring
