17/04/2026
最新突破，雷射神經燒灼手術如何大幅度降低手術後嚴重出血的併發症。
在許多患者的諮詢中，都會見到黃醫師手中三個不同的術式介紹。
有解決一般鼻塞的一般無線射頻(RFIT)
有加強後鼻腔過敏改善的無線射頻包含後鼻神經燒灼(RAPN)
有加上雷射設備作為擴大後鼻神經燒灼手術(LPN3)
以及全部一起做的RPN3 = RFIT + RAPN + LPN3
我們在門診中都會有清楚的解釋每一項手術預期的成果，雖然濃縮成一兩句話，但每句話背後都有紮實的實證數據。
單做一般無線射頻(RFIT)最接近大家在一般耳鼻喉科與過去的手術經驗中取得的治療，也是歷史悠久與相對輕鬆的做法。
在最保守的治療方式中，甚至可以在麻醉後2分鐘左右就做完一邊。
所以在回顧文獻與各項設備比較中，常常看到無線射頻容易復發或改善不好，其實他本身有非常大的操作差異。
所以除非非常少數的狀況，黃醫師也很少單做RFIT。
針對很嚴重的鼻塞與一般程度的過敏，黃醫師目前手術主力就是加強後鼻腔過敏改善的無線射頻包含後鼻神經燒灼Radiofrequency ablation of inferior turbinates including intrasegment posterior nasal nerve(RAPN)。
因為在已經發表的文獻中，已經知道只要達到這個深度的治療，在一個嚴重度以下的患者，就可以達到與合併雷射神經燒灼(RPN3)依樣的效果。
所以在我們的治療當中，我們會評估每一位患者的嚴重度，依據最新的實證建議，參考每個人的需要來建議不同的治療。
並不是每個人都需要手術，也不是治療範圍越大越好。
最新的文章發表式確立了LPN3的地位，同時也弄清楚了他所有的手術參數與特性。
我們成功地證明了可以用避開測後鼻壁上面的後側鼻動脈PLNA僅做前後的雷射燒灼，就可以重現歷史上已經發表過幾篇最指標的文章的成果。
具體作法包含
1. 必須先使用含血管收縮劑的鼻棉使側鼻壁黏膜去充血
2. 使用0度硬式內視鏡在中鼻甲與下鼻甲之前停留
3. 觀察耳咽管前方0.5-1cm處會有黏膜下血管搏動的痕跡
4. 若沒有找到可以輕微翻開中鼻甲先找出SPA根部在往下找
5. 若還是找不到可以從下鼻甲和側鼻壁交界找進入端會很淺
6. 還是找不到可以用雷射用1W試打一條白線增加對比幫助觀察
7. 最後還是不行代表血管可能在更深處或不在手術範圍
證實了更精細的手術，更安全，一樣有效。
最後我們也公布了我們首先推出的手術技巧PLNA detection technique發表在國際期刊影片上，讓全世界一起交流。
以前閱讀就了解到，華人文化常常喜歡獨門秘笈，最厲害的絕招不輕易外流，但是西方文化可以讓科學快速發展和科技快速進步，就在於公開交流的學術文化與專利權的保護、私有財產制保障了科技的研發。
所以我們選擇讓所有研究內容都公開上網，因為我們相信經過最強大的檢驗，才能證實他真的是有效的，並成為一門科學讓全人類一起進步。
最後就是我們的RPN3，是綜合所有的術式一起合作在30分鐘局部麻醉完成對慢性鼻炎、鼻塞過敏、睡眠品質不好、日間嗜睡的狀況一起做一個綜合改善。
在過去3年我們已經成功完成了超過2300例綜合以上各類術式的手術，每幾個月黃醫師就會重新評估手術過病患變化，確認療效。
這是一個探索未知的旅程，我們非常開心能有很棒的團隊成員持續努力。也有來自全台灣無數耳鼻喉科醫師的交流與鼓勵，讓我們相信我們做出了實質的貢獻。
我們會持續努力，繼續在這個領域深化，一起為這個領域的知識做出更多貢獻。
Latest Breakthrough: How Laser Nerve Ablation Significantly Reduces Post-Operative Hemorrhage Complications
During patient consultations, Dr. Huang frequently presents three distinct surgical approaches tailored to different needs:
RFIT (Radiofrequency Ablation of Inferior Turbinates): Addresses general nasal congestion.
RAPN (Radiofrequency Ablation including Posterior Nasal Nerve): Enhances improvement for posterior nasal allergies.
LPN3 (Laser Posterior Neurectomy): Utilizes laser equipment for an expanded posterior nasal nerve ablation.
RPN3 (RFIT + RAPN + LPN3): A comprehensive procedure combining all three techniques.
In our clinic, we provide clear explanations of the expected outcomes for each procedure. While these may be condensed into a sentence or two, every statement is backed by solid empirical data.
The Evolution of RFIT and RAPN
Performing RFIT alone is most similar to the traditional treatments found in general ENT practices; it is a time-tested and relatively "easy" approach. Under the most conservative methods, one side can even be completed in about two minutes after anesthesia.
Literature reviews often suggest that radiofrequency ablation has a high recurrence rate or suboptimal results; however, this is largely due to significant variations in surgical ex*****on. Consequently, except for rare cases, Dr. Huang seldom performs RFIT as a standalone procedure.
For severe nasal congestion and moderate allergies, Dr. Huang’s primary surgical choice is RAPN (Radiofrequency ablation of inferior turbinates including intrasegment posterior nasal nerve). Published literature indicates that for patients below a certain severity threshold, reaching this depth of treatment achieves results identical to the combined laser procedure (RPN3).
Precision Over Intensity
We assess the severity of each patient’s condition and recommend different treatments based on the latest evidence-based suggestions and individual needs. Not everyone requires surgery, and "larger" treatment areas are not always better.
Our latest publication has solidified the status of LPN3 while clarifying its surgical parameters and characteristics. We have successfully demonstrated that by avoiding the Posterior Lateral Nasal Artery (PLNA) on the lateral posterior nasal wall—applying laser ablation only to the anterior and posterior sections—we can replicate the results of the most landmark studies in history.
Specific Surgical Procedures
1. Decongestion: First, nasal packing soaked with a vasoconstrictor must be used to thoroughly decongest the mucosa of the lateral nasal wall.
2. Endoscopic Positioning: Use a 0 degree rigid endoscope to visualize the area between the middle turbinate and the inferior turbinate.
3. Visual Identification: Observe the region approximately 0.5–1 cm anterior to the Eustachian tube or***ce for traces of submucosal vascular pulsations.
4. Alternative Mapping: If the pulsations are not immediately visible, gently medialize the middle turbinate to locate the root of the Sphenopalatine Artery (SPA) and trace downwards.
5. Anatomical Landmarks: If the vessel remains hidden, examine the junction of the inferior turbinate and the lateral nasal wall; the entry point is often quite superficial at this location.
6. Laser Contrast Enhancement: If identification is still difficult, use a laser at 1W to create a thin "white line" on the mucosa. This increases visual contrast and helps in identifying underlying structures.
7. Surgical Conclusion: If the vessel cannot be located after these steps, it likely indicates that the artery is located in a deeper plane or lies outside the intended surgical field.
Our latested RCT demontrated that a more refined surgery is safer, yet equally effective.
Open Science for Global Progress
Finally, we have released our pioneered PLNA detection technique via a video in an international journal to facilitate global academic exchange.
Historically, some cultures prioritized "secret techniques" that were never shared. In contrast, Western scientific advancement has thrived on a culture of open exchange, patent protection, and private property rights, all of which incentivize R&D.
We have chosen to make all our research findings available online. We believe that only through the most rigorous scrutiny can a method be proven truly effective, evolving into a science that drives progress for all of humanity.
Finally, we have our RPN3—a comprehensive procedure that integrates all the aforementioned techniques. Performed in just 30 minutes under local anesthesia, it provides a holistic improvement for chronic rhinitis, nasal congestion, allergies, poor sleep quality, and daytime sleepiness.
Over the past three years, we have successfully completed more than 2,300 cases utilizing these various surgical combinations. Every few months, Dr. Huang re-evaluates the progress of post-operative patients to monitor and confirm the long-term efficacy of the treatments.
This has been a journey of exploring the unknown, and we are incredibly fortunate to have a dedicated team working alongside us. We are also grateful for the exchange of ideas and encouragement from countless ENT specialists across Taiwan, which reaffirms our belief that we are making a substantive contribution to the field.
We will continue to work hard, deepening our expertise in this area to collectively contribute knowledge of this field.
