Effectiveness Of Radiofrequency Thermal Ablation Research Articles

The Effectiveness of Radiofrequency Thermal Ablation in the Treatment of Patients with Osteoid Osteomas of the Spine

Osteoid osteoma is a rare benign osteogenic bone tumor without malignant potential causing severe night pain relieved by nonsteroidal anti-inflammatory drugs. Pain associated with osteoid osteoma of the spine cannot be treated conservatively and requires surgical approach. Types of surgical treatment include intralesional curettage, marginal resection, or en bloc tumor resection. However, absence of clear intraoperative visualization of the lesion often leads to excessive resection of vertebral structures requiring additional bone reconstruction and fixation with metal structures. In some cases, due to incorrect choice of resection area and segment level, repeat surgeries are performed causing secondary spinal deformations, worsening patient’s condition, and increasing economic expenditures. Currently, minimally invasive methods of transcutaneous treatment of osteoid osteomas such as interstitial laser ablation, cryotherapy, and radiofrequency thermal ablation are becoming more prominent.Aim. To evaluate the effectiveness of radiofrequency thermal ablation treatment in patients with osteoid osteoma.Materials and methods. The prospective study included 12 patients with osteoid osteoma of the spine. Their quality of life was evaluated using the Short Form-36 (SF-36) questionnaire prior to radiofrequency thermal ablation and 30, 90 and 180 days after. At the first visit and during observation, pain syndrome intensity was measured using the Visual Analog Scale (VAS) and R.G. Watkins scale for objective evaluation of pain syndrome per number of analgesics administrations.Results. Follow-up duration varied between 12 and 36 months. In all clinical cases, general, physical, and psychological health improved 2–3-fold. Pain intensity at day 1 after radiofrequency thermal ablation compared to mean pain intensity during the day prior to the procedure was significantly lower (р = 0.05). At the final examination, none of the patients had pain (pain syndrome intensity 0 per VAS); all patients had subjective satisfaction level of 100 %. Analgesics (nonsteroidal anti-inflammatory drugs and paracetamol) were administered on request for 8 ± 2.34 days after the procedure.Conclusion. Based on literature data and our own experience of diagnosis and surgical treatment of osteoid osteoma of the spine, we conclude that in cases of small lesions (<2 cm) in hard to access locations, computed tomography-controlled radiofrequency thermal ablation allows to perform surgical intervention safely, effectively and with minimal number of complications.

Treatment of maxillofacial congenital melanocytic nevus with percutaneous radiofrequency thermal ablation: A case series study.

When congenital melanocytic nevus (CMN) is in the maxillofacial region, a safer, more effective and fewer side-effects treatment is needed for patients with high requirement for appearance. The objective of this study was to investigate the effectiveness of radiofrequency thermal ablation (RFA) for CMN in the maxillofacial region. We reviewed 21 patients treated with RFA for CMN followed by a blinded retrospective analysis of serial photographs taken during the course of their therapy. Questionnaires were used to evaluate perceived therapeutic response and complications of this treatment. Most CMNs stopped growing, faded in color and became smaller. Reduction in size of 90% to 100% was obtained in two patients (10%), 75% to 90% in six patients (29%), 50% to 75% in two patients (10%), <50% in eight patients (38%), and three had no reduction (13%). Clear effect of clinical response score was obtained in two patients (10%), excellent in four patients (19%), good in 14 patients (67%), and fair in one patient (4%). No serious complication, severe hypertrophic scarring, and evidence of recurrence was observed in any case. Percutaneous RFA, as a minimally invasive and safe treatment, may provide an alternative treatment for maxillofacial CMN.

Comparison of the long term efficacy of radiofrequency ablation and surgical turbinoplasty in inferior turbinate hypertrophy: a randomized clinical study

Objective: To compare the long term effectiveness of radiofrequency thermal ablation with that of surgical turbinoplasty, a prospective, randomized, blinded clinical study was conducted.Methods: Eighty six patients suffering from nasal obstruction due to bilateral inferior turbinate hypertrophy were enrolled. Forty four patients were operated by radiofrequency ablation, while 42 underwent surgical turbinoplasty. The outcomes of both techniques were compared in terms of symptoms using visual analogue score (VAS) and endoscopic scores.Results: A statistically significant difference in the VAS scores existed between the two groups by the 3rd month in terms of nasal obstruction (p=.0002) and headache (p=.0001), by the 6th month in terms of nasal secretions (p=.007), by the end of 1 year in terms of sneezing (p=.023) and no statistically significant difference even till the end of year with respect to hyposmia.Conclusions: Radiofrequency thermal ablation is more effective than surgical turbinoplasty in terms of treating nasal obstruction and equally effective in terms of managing sneezing. Radiofrequency ablation has the advantage of being a day care procedure and minimal complications.

Comparison of Radiofrequency Thermal Ablation and Microdebrider-Assisted Turbinoplasty in Inferior Turbinate Hypertrophy: A Prospective, Randomized, and Clinical Study.

To compare the effectiveness of radiofrequency thermal ablation with those of microdebrider-assisted turbinoplasty, we designed a prospective, randomized clinical study. Forty patients suffering from nasal obstruction due to bilateral inferior turbinate hypertrophy were enrolled. Half of the patients were operated by radiofrequency thermal ablation, while the other half underwent microdebrider-assisted turbinoplasty. The outcomes of both techniques were compared in terms of symptomatology, nasal patency, and mucociliary transport. A statistically significant difference existed between the two groups with respect to nasal obstruction and the frequency of obstruction at the first post-operative week and first and third post-operative months (p<0.05). Rhinomanometry detected a significant decrease in nasal resistance values in both surgical groups compared to the preoperative values. The mucociliary transport time was significantly prolonged in the first postoperative week and first postoperative month in microdebrider-assisted inferior turbinoplasty group. Both radiofrequency thermal ablation and microdebrider-assisted turbinoplasty are effective techniques for treating inferior turbinate hypertrophy. The treatment modality should be individually determined, and parameters such as tissue healing, volume reduction, and mucociliary activity must be taken into account.

Radiofrequency Thermal Ablation versus Bipolar Electrocautery for the Treatment of Inferior Turbinate Hypertrophy: Comparison of Efficacy and Postoperative Morbidity.

Introduction Numerous surgical methods are used to treat nasal obstruction due to inferior turbinate hypertrophy. The primary goal of the therapy is to maximize the nasal airway for as extended a period of time as possible while minimizing therapeutic complications. Objectives The aim of this study was to assess the effects of radiofrequency thermal ablation (RFTA) and bipolar electrocautery (BEC) on the removal of nasal obstruction in patients with inferior turbinate hypertrophy and on nasal mucociliary clearance (MCC). Patients in both groups were also evaluated in terms of postoperative morbidity. Methods We compared the outcomes of two groups of patients: those treated with RFTA (n = 23) and those who underwent BEC (n = 20). Nasal obstruction was graded using a visual analog scale (VAS) and MCC was measured using a saccharin clearance test. Both measurements were performed before and 2 months after treatment. Results Pre- and postoperative VAS scores showed significant improvement for both groups. However, MCC results did not significantly differ between two groups. Neither edema nor crust formation persisted for more than 1 week in any patients. Conclusion Submucosal cauterization with preservation of the nasal mucosa and periosteum is as effective and safe as RFTA and should be considered when planning inferior turbinate interventions.

Effects of radiofrequency thermal ablation on the nasal cycle measured using rhinomanometry.

This study was designed to research the effects of radiofrequency thermal ablation (RFTA) surgery on the nasal cycle, with anterior rhinomanometry being used for assessment. Thirty patients with inferior concha hypertrophy and 13 healthy volunteers were included in this study. An anterior rhinomanometry was performed on each of the patients before surgery and at 1 month and 6 months after surgery, and on the volunteers in the control group, simultaneously. Nineteen of the 30 patients and 8 of the 13 healthy participants showed a distinct type of nasal cycle at different periods of measurement. The mean of the total nasal airflow of the patients was lower before RFTA surgery but increased at a rate of 71.07%, closer to the value of the control group, after RFTA surgery. After RFTA, the unilateral nasal airflow (fmin and fmax) values increased at ratios of 22.36% and 94.44%, respectively. The amplitude (fmax-fmin) showed a statistically significant decrease in the postoperative period (108.43 ± 54.37), when compared with that of the preoperative period (202.80 ± 81.24) (P < .01). We conclude that the RFTA is a useful method for treating inferior concha hypertrophy, because it positively affects the nasal physiology, increasing the total nasal airflow without changing the nasal cycle time.

Long-term results of transnasal radiofrequency in patients with obstructive sleep apnea syndrome

This study aims to investigate the long-term effects of radiofrequency thermal ablation (RFTA) performed to the inferior concha on snoring, apnea index, and daytime sleepiness symptoms in patients who presents with the complaint of snoring and mild obstructive sleep apnea syndrome (OSAS). Between March 2009 and May 2011, 50 patients (29 females, 21 males; mean age 40.7 years; range 19 to 64 years) who had witnessed sleep apnea and diagnosed with mild OSAS as assessed by polysomnographic analysis in our clinic were included in the study. Twenty-five patients with the history of witnessed sleep apnea underwent sleep analysis using conventional polysomnography (PSG), while portable PSG device was used in other 25 patients. During the follow-up visits, all patients who underwent tissue ablation using RF were assessed by the baseline examination method. Following the polysomnographic analysis, RFTA was performed to the inferior concha of all patients. The mean follow-up period was 18.7 months (range 6-26 months). In the group who underwent conventional PSG, the mean pre-treatment apnea-hipopnea index (AHI) was 11.356±2.9841, while the mean post-treatment AHI was 9.93±2.822. In the group who underwent portable PSG, the mean pre-treatment AHI was 9.196±3.2696, whereas the mean post-treatment AHI was 8.04±3.241. In two patients (4%), inferior concha ulceration was detected. Radiofrequency used in the treatment of mild OSAS results in better patient compliance and post-treatment patient comfort, as well as lower post-treatment morbidity and complication rate, compared to conventional surgical techniques.

Ultrasound-guided thermal radiofrequency ablation (RFA) as an adjunct to systemic chemotherapy for breast cancer liver metastases

The aim of this study was to evaluate the effectiveness of radiofrequency thermal ablation (RFA) of liver metastases from breast cancer and its impact on survival. Thirteen female patients (age range 36-82 years; median 54.5 years) underwent RFA for the treatment of 21 liver metastases from breast cancer. The procedures were performed under ultrasound (US) guidance using an RF 2000 or RF 3000 generator system and Le Veen monopolar needle electrodes. Follow-up was carried out by computed tomography (CT) after 1, 3, 6 and 12 months. Technical success was 100%. No major or minor complications occurred at the end of the procedure. In our series, 7/21 lesions in 7/13 patients increased in size at 7, 18, 19 and 38 months. This resulted in a mean disease-free interval of 16.6 months. Mean overall survival after RFA was 10.9 months. RFA appears to be a useful adjunct to systemic chemotherapy and/or hormone therapy in the locoregional treatment of hepatic metastases from breast cancer. RFA may also be a less invasive alternative to surgery in the locoregional treatment of liver metastases from breast cancer.

Long-term histological examination of inferior concha after radiofrequency thermal ablation

To examine the histological effects of radiofrequency thermal ablation on the inferior concha epithelium and subepithelium, over five years post-treatment. Inferior nasal concha epithelial biopsy specimens were examined histologically before and four, 30, 48 and 60 months after radiofrequency treatment, in six patients with inferior nasal concha hypertrophy. At four months post-treatment, there was proliferation of blood vessels, increased inflammatory cells and a slightly decreased number of glands. At 30 months post-treatment, the number of inflammatory cells and glands had decreased, but signs of increased vascular proliferation, fibrosis and granulation were seen. At 48 and 60 months post-treatment, the number of inflammatory cells and blood vessels had decreased significantly, the number of glands had increased, and lobulation was observed. Radiofrequency thermal ablation does not cause carbonisation or osteitis in the inferior concha. The resultant fibrosis causes contraction of the concha and only minor tissue destruction (as shown by the persistence of submucosal glands).

Biologic effects of radiofrequency thermal ablation on non–small cell lung cancer: Results of a pilot study

Radiofrequency ablation of lung tumors is an emerging technique with promising results. To achieve more information on its effects on pulmonary parenchyma and primary tumors, and to assess its efficacy in determining complete necrosis of the lesion, we led a pilot study consisting of thermal ablation followed by surgical resection. Ten patients with early stage non-small cell lung cancer were enrolled in the study. In 5 patients radiofrequency ablation was achieved through thoracotomy just before the surgical resection. In another 5 patients radiofrequency ablation was performed percutaneously, under computed tomography guidance, and the surgical resection was performed after 15 days. Nine of the 10 patients enrolled in the study were available for analysis. There were 8 men and 1 woman with a mean age of 65.5 years. In all cases histologic diagnosis was available before radiofrequency ablation; adenocarcinoma was identified in 5 patients, and squamous cell carcinoma was identified in 4 patients. Microscopic examination showed complete necrosis of the tumor in 6 of 9 cases. No anatomopathologic alterations were seen in surrounding distant parenchyma. Our study confirms the safety of radiofrequency ablation, particularly underlining the possibility of performing a thermal lesion in the lung in a controlled manner. It also assesses that radiofrequency ablation may be effective in the local control of primary lung cancer. However, surgery still represents the mainstay of treatment of non-small cell lung cancer, and radiofrequency ablation must be reserved for high-risk patients.

Laparoscopic Radiofrequency Thermal Ablation of Hepatocarcinoma: Preliminary Experience

The objective was to evaluate the feasibility, safety, and effectiveness of radiofrequency thermal ablation (RFT), performed during laparoscopy with a cooled-tip electrode needle, in the treatment of neoplastic hepatic focal lesions. Seven patients with hepatocarcinoma (10 hepatic lesions) were treated during laparoscopy with RFT using a 100-watt RF generator and 17-gauge, dual-lumen, cooled-tip electrode needles with a 3-cm exposed tip. The mean exposure time was 12 minutes for each needle insertion. Spiral computed tomography scanning detected complete tumor necrosis in nine lesions; in one lesion, peripheral neoplastic tissue was detected, and percutaneous RFT was performed. Two patients during follow-up developed two new neoplastic lesions, treated with percutaneous ethanol injection. No recurrences of the treated lesions were seen after 6 months of follow up. Intraoperative RFT with a cooled-tip electrode needle is a safe and effective local treatment of hepatic focal lesions during laparoscopic surgery. Possible indications are large hepatocarcinoma (>5 cm), superficial lesions, multiple lesions, or tumor located near vascular or biliary structures.