Holmium: YAG Laser in Endoscopic Sinus Surgery

The newly developed holmium: YAG (Ho: YAG) laser was applied to endoscopic sinus surgery. This laser deliveres light energy through a fiberoptic cable which is well suited for en-doscope-assisted endonasal surgery. The most characteristic property of the Ho: YAG laser is sufficient ablation of bone tissues and minimal thermal damage to the surrounding normal tissues. We used the Ho: YAG laser for inferior turbinectomy (5 cases), marsupialization of paranasal sinus mucoceles with bony thickening (10 cases), and dacryocystorhinostomy (DCR, 2 cases). The inferior turbinates were easily ablated by the laser with minimal bleeding, and a better visualization of the medial wall of the maxillary mucoceles was obtained. The surgery successfully opened paranasal sinus mucoceles in all patients. Endoscopic laser DCR achieved removal of the thick bone along the lateral wall of the nasal cavity to expose the lacrimal sac. There were no intraoperative or postoperative complications. The present results indicate that the Ho: YAG laser is a useful tool for bone ablation in endoscopic sinus surgery.