Radiofrequency Turbinoplasty Research Articles

Topical Anesthesia Versus Submucosal Injection for Radiofrequency Turbinoplasty: Same Benefit but without Patient's Pain. A Comparative Study.

This study aimed at comparing the anesthetic efficacy of lidocaine injection versus pledgets soaked in lidocaine and epinephrine during radiosurgery of inferior turbinates. The study prospectively enrolled 120 outbound patients, who were randomly assigned to group 1 -anaesthesia with tampon soaked in lidocaine and adrenaline- or group 2 -anesthesia with tampon followed by lidocaine and adrenaline injection. The following parameters were evaluated by a visual analogue scale 1h after surgery: pain, anxiety, chocking sensation and difficulty swallowing. Nasal obstruction, rhinorrhea, sneezing, headache and inferior turbinate size were evaluated preoperatively (T0), after 1 (T1), 2 (T2) and 3 months (T3) to surgery. The data collected were analyzed by statistic tests. Group 1 showed lesser pain than group 2 during the procedure (p < 0.01); no statistically significant differences were observed for anxiety, chocking sensation and difficulty swallowing. All patients, independently from the belonging group, significantly improved the nasal symptoms comparing T0 and T1 (p < 0.01), T2 (p < 0.01) and T3 (p < 0.01), without statistically significant differences among the groups. Radiofrequency turbinoplasty allowed to all patients to reduce the turbinates hypertrophy. Local anaesthesia with tampon allowed to obtain the same results the injective anaesthesia in term of surgical outcomes; the use of tampon allowed patients did not experience pain.

Development of High-Intensity Focused Ultrasound Therapy for Inferior Turbinate Hypertrophy.

ObjectivesInferior turbinate (IT) hypertrophy is the main cause of chronic nasal obstruction. We developed a high-intensity focused ultrasound (HIFU) ablation device to treat patients with IT hypertrophy.MethodsFirst, computed tomography images of patients with no evidence of sinonasal disease were evaluated to measure and compare the IT, medial mucosal thickness (MT), and space between the nasal septum and IT according to clinical characteristics such as septal deviation. A HIFU prototype was developed based on the above human anatomical studies. The experimental study was performed in five pigs; the nasal volume and histological changes at 1 and 4 weeks postoperatively were evaluated to compare the efficacy of HIFU turbinoplasty with that of radiofrequency turbinoplasty and a control group.ResultsThe mean medial MT of the anterior, middle, and posterior portions of the IT were 4.66±1.14, 4.23±0.97, and 6.17±1.29 mm, respectively. The mean medial space was 2.65±0.79 mm. The diameter and focal depth of the prototype were 4 mm and 3 mm, respectively. HIFU showed no postoperative complications, including bleeding or scar formation. After HIFU treatment, the nasal volume increased by 196.62 mm3 (7.8%) and 193.74 mm3 (8.3%) at 1 week and 4 weeks, compared with the increase of 87.20 mm3 (3.1%) and 213.81 mm3 (9.0%), respectively,after radiofrequency therapy. A qualitative histological analysis after radiofrequency turbinoplasty showed epithelial layer disruption at 1 week and increased fibrosis, along with decreased glandular structure, at 4 weeks. The HIFU group had an intact epithelial layer at 1 week postoperatively. However, significant differences were observed at 4 weeks, including increased fibrosis and decreased glandular structure.ConclusionThe efficacy and safety of HIFU turbinoplasty were demonstrated in an animal study. Our results warrant further human clinical trials.

Comparison of Radiofrequency and Microdebrider-Assisted Turbinoplasty for Treatment of Isolated Inferior Turbinate Hypertrophy

Comparison of Radiofrequency and Microdebrider-Assisted Turbinoplasty for Treatment of Isolated Inferior Turbinate Hypertrophy

A Comparative Study of Conventional Surgical Turbinoplasty Versus Microdebrider Assisted Turbinoplasty Versus Radiofrequency Assisted Turbinoplasty in Cases of Inferior Turbinate Hypertrophy

AbstractBackground: Nasal obstruction is the most common complaint among patients presenting to otolaryngologists which disturbs the quality of life of the patient. The anterior end of inferior turbinate is the narrowest part of nasal airway, its enlargement cause significant nasal obstruction [1].Patients and Methods: During the period from December 2015 to October 2017, the mean age was ranging from 17 years to 46 years; fifteen patients were females (50%) while fifteen patients were females (50%) were attending Otorhi-nolaryngology Department, Al-Zahraa University Hospital, with nasal obstruction and diagnosed as hypertrophied inferior turbinate refractory to medical treatment. The 30 patients selected for this study were randomly assigned to undergo conventional surgical turbinoplasty (n=10), microdebrider assisted turbinoplasty (MD) (n=10), and Radiofrequency turbinoplasty (RF) (n=10).Results: Microdebrider assisted turbinoplasty is the tech-nique of highest efficacy and leastcomplication. Radiofre-quency turbinoplasty is alternative method for the treatment of turbinate hypertrophy. It is the simplest technique and its efficacy is high in long-term olfactory and functional Out-comes. Conventional surgical turbinoplasty is effective as microdebrider but the complication namely crustation and bleeding in this method is higher and time consuming than the other 2 methods.Conclusion: Both radiofrequency and microdebrider assisted turbinoplasty are efficient methods for relieving nasal obstruction related to inferior turbinate hypertrophy.

Radiofrequency turbinoplasty for nonallergic rhinitis in geriatric patients.

Radiofrequency (RF) turbinoplasty may be effective in treating nonallergic rhinitis in elderly patients. The present study evaluated the efficacy of nasal turbinate surgery with RF for the treatment of nonallergic rhinitis in elderly patients refractory to medical therapy. A total of 35 consecutive patients older than 65 years of age (mean subject age, 75.5 ± 9.6 [standard deviation] years) with nonallergic rhinitis refractory to medical therapy who underwent RF turbinate surgery were enrolled in this study. The efficacy of RF turbinoplasty in treating nonallergic rhinitis in elderly patients was evaluated by using rhinoscopy and a visual analog scale score of nasal symptoms. The response rate of primary RF turbinate surgery for nonallergic rhinitis refractory to medical therapy was 68.6%. Postoperative symptom scores for rhinorrhea and nasal obstruction were significantly improved. Persistent crust formation developed in seven patients (20.0%). No patient experienced major complications (e.g., septal hematoma, abscess, septal perforation), but partial bone necrosis was observed in one patient. RF turbinoplasty appeared to be effective for treating some nonallergic rhinitis symptoms in elderly patients, including rhinorrhea and nasal obstruction. These preliminary results are encouraging and warrant further investigation.

The effect of radiofrequency turbinoplasty vs two other methods in the management of polypoid changes of the middle turbinate: a randomized trial.

The aim of this study was to evaluate the effectiveness of middle turbinate radiofrequency (RF) turbinoplasty for the management of the polypoid middle turbinate compared to middle turbinate resection and middle turbinate medialization. The study was performed on 90 patients at a tertiary referral hospital with nasal polyposis resistant to maximal medical treatment. At the time of functional endoscopic sinus surgery (FESS), patients were randomized into 3 groups with respect to the management of the middle turbinate: middle turbinate turbinoplasty by RF; partial resection of the middle turbinate; and medialization of the middle turbinate by scarification to the septum. We evaluated the patients' symptoms according to the 22-item Sino-Nasal Outcome Test (SNOT-22) preoperatively and 1 year after surgery. Additionally, polyp recurrence and complications were compared among the 3 groups. One year after surgery, there was no significant difference in SNOT-22 scores between the groups. However, the RF group had a significantly lower polyp recurrence rate when compared to other groups (p < 0.05). RF middle turbinate turbinoplasty could be considered an alternative to other common approaches, but it needs further long-term studies before widespread usage.

Long-term effect of radiofrequency turbinoplasty in nasal obstruction

The aim of this retrospective study is to investigate long term (two years) effect of radiofrequency tissue volume reduction (RFVTR) on nasal obstruction associated with inferior turbinate hypertrophy, which is not respond to medical treatment. This retrospective study carried out on 98 patients with nasal obstruction treated by RFVTR (56 males, 42 females, from 17 to 70 years of age). Visual analogue scales (VAS) and nasal endoscopic view score (NES) were used for nasal obstruction to evaluate the efficacy of the treatment. Results of one, three, six, twelve and twenty four months after RFVTR treatment were compared with pre-exposure values. Turbinate edema and nasal obstruction in the treated patients were recovered after one month of treatment (p < 0.01). Maximum improvement were determined at the end of third month (p < 0.01). However, eficacy of RFVTR declined twelve months after treatment. Final percentage of imrovement was found as 51 % at the end of second year of treatment because of co-factors was not eliminated by some patients. On the other hand, no statistical significant difference was observed between the right and left nasal cavity (p < 0.001). In conclusion, the result of this study indicated that patients who have not eliminate co-factors such as smoking, obesity and allergic rhinitis may need re-application of RFTVR. However, further studies on radiofrequecy energy level and elimination of other co-factors are necessary to illuminate the eficacy of RFVTR.

Long-term Results of Radiofrequency Turbinoplasty for Allergic Rhinitis Refractory to Medical Therapy

Long-term Results of Radiofrequency Turbinoplasty for Allergic Rhinitis Refractory to Medical Therapy

Intranasal steroids or radiofrequency turbinoplasty in persistent allergic rhinitis: effects on quality of life and objective parameters

Nasal congestion is a cardinal symptom of allergic rhinitis (AR). It is associated with decreased quality of life and difficult to treat as perceived by the patients. The purpose of this study is to evaluate the mid-term objective and subjective outcomes of management of nasal congestion using intranasal steroid (INS) therapy or radiofrequency turbinoplasty (RFT) in patients with persistent AR who have mucosal hypertrophy of the inferior turbinate. Fifty-five adult patients with AR, who claimed nasal congestion refractory to oral antihistamine (desloratadine) therapy, were randomized to INS (mometasone furoate) or temperature-controlled RFT treatment groups. Outcomes were determined by active anterior rhinomanometry, visual analog scale (VAS), and rhinoconjunctivitis quality of life questionnaire (RQLQ) at least 12 months after treatment. The median total nasal resistance decreased from 0.49 ± 0.17 to 0.39 ± 0.12 Pa/cm(3)/s (p = 0.42), and from 0.51 ± 0.18 to 0.29 ± 0.07 Pa/cm(3)/s (p = 0.003) with INS and RFT, respectively. RFT provided a better reduction in the perception of congestion in VAS scores. RQLQ scores improved significantly in both groups 1 year after treatment (mean follow-up 14.2 months) (p < 0.05). No adverse reactions were encountered in either group. Nasal congestion refractory to antihistamine appears to be improved by INS at some point, while reduced significantly by RFT in objective and subjective parameters. Both options are also effective in increasing the quality of life in patients with AR. RFT might be a safe and effective treatment of option in AR compared with INS.

Long-term Results of Radiofrequency Turbinoplasty for Allergic Rhinitis Refractory to Medical Therapy

To study the long-term outcomes of radiofrequency (RF) turbinate surgery for the treatment of allergic rhinitis refractory to medical therapy. A retrospective review of a prospective data set. Tertiary referral center. A total of 146 patients with allergic rhinitis refractory to medical therapy undergoing RF turbinoplasty were included. A standard 0 to 10 visual analog scale (VAS) was used to assess the allergic symptoms including nasal obstruction, rhinorrhea, sneezing, itchy nose, and itchy eyes prior to RF turbinoplasty and at 6 months and 5 years postoperatively. The long-term clinical benefits and complications were reviewed. Statistical analysis was determined by repeated measures of analysis of variance. No adverse reactions such as bleeding, infection, adhesions, or olfactory change were encountered. Of the 146 patients, 119 were followed up at least 5 years postoperatively. Five years after treatment, 101 patients had complete data available for analysis. They reported improvement of nasal obstruction, with the mean (SD) VAS score decreasing from 6.65 (1.92) to 4.45 (2.54). The mean (SD) VAS score changed from 5.90 (2.79) to 3.79 (2.97) for rhinorrhea; from 5.15 (2.77) to 3.50 (2.77) for sneezing; from 3.67 (3.03) to 2.41 (2.30) for itchy nose; and from 2.94 (3.02) to 2.02 (2.42) for itchy eyes (all P<.001, paired t test with Bonferroni correction). This long-term study has demonstrated that the RF turbinoplasty for allergic rhinitis appears to be an effective and safe tool for treating allergic rhinitis refractory to medical therapy.

Radiofrequency Turbinoplasty in Imidazoline-induced Rhinitis Medicamentosa

ABSTRACT Aim To evaluate the efficacy and results of radiofrequency turbinoplasty in patients with rhinitis medicamentosa due to imidazolines like oxymetazoline and xylometazoline. Study design This is a prospective, single-blinded, randomized controlled study. Materials and methods Study was conducted on 20 patients in a tertiary level center from January 2010 to February 2016. Patients with symptoms and signs of nasal obstruction due to rhinitis medicamentosa were selected. Patients were aged from 16 to 43 years (mean age is 24 years). Twelve were males and eight were females. The duration of use of nasal decongestant drops varied from 3 months to 5 years. The turbinoplasty was performed using the radiofrequency method. Nasal obstruction symptom evaluation (NOSE) questionnaires are used for subjective assessment and nasal endoscopy view score (NES) was used for objective assessment pre- and postoperatively. Follow-up was done at the end of 15 days and 3 months after surgery. The results were statistically analyzed by paired t-test. Results The mean NOSE score before procedure was 92. At the 15th postoperative day, mean NOSE score reduced to 1.3 and it further reduced at the 3rd month to 0.5 (p &lt; 0.001), with 99.5% reduction in subjective symptoms. The mean NES before procedure was 3.95. On the 15th day, it was 0.35 and at the end of 3rd month, it was 0 with 91.1% reduction in objective evaluation (p &lt; 0.001). Results were same on left and right side of nose. No major postoperative complication was observed in patients. Conclusion Radiofrequency turbinoplasty technique can be recommended as an effective method in imidazoline-induced rhinitis medicamentosa. It is simple, comfortable, fast relief giving, no repeated steroids, and cost-effective, single-session treatment. Good compliance and cooperation from patients can be obtained with no major complications of the treatment. It allows patients to be managed in the office environment. How to cite this article Rao SVM. Radiofrequency Turbinoplasty in Imidazoline-induced Rhinitis Medicamentosa. Clin Rhinol An Int J 2017;10(2):53-57.

S285 – Long-Term Efficacy of RF Turbinoplasty for Allergic Rhinitis

Objectives To study the long-term outcomes of radiofrequency turbinoplasty for the treatment of allergic rhinitis. Methods 146 consecutive patients who underwent radio-frequency turbinoplasty due to allergic rhinitis refractory to medical therapy were enrolled in this study. A 0–10 visual analog scale (VAS) was used to assess the allergic symptoms including nasal obstruction, rhinorrhea, sneezing, itchy nose, and itchy eyes preoperatively and 5 years postoperatively. The long-term clinical benefits and complications were reviewed. Statistical analysis was determined by paired t-test. Results None of the patients had obvious discomfort except mild numbness over the teeth (27/146, 18.5%) during operation. No long-term adverse reactions, including bleeding, infection, adhesion, or olfactory change were encountered. 119 patients had a minimum follow-up of 5 years and complete data available for analysis. The response rate was 60.5% (72/119). 18 patients received additional nasal surgery due to no obvious response to the surgery. These patients were excluded from the final analysis. 5 years after the treatment, the other 101 patients obtained improvement of nasal obstruction, with the VAS degree changing from 6.65 ± 1.92 to 4.45 ± 2.54 (p&lt;0.0001). The VASs of rhinorrhea, sneezing, itchy nose, and itching eyes changed from 5.90 ± 2.79 to 3.79 ± 2.97, 5.15 ± 2.77 to 3.50 ± 2.77, 3.67 ± 3.03 to 2.41 ± 2.30 and 2.94 ± 3.02 to 2.02 ± 2.42, respectively (all p&lt;0.0001). Conclusions The long-term study demonstrated that radiofrequency turbinoplasty appears to still be effective and safe for treating allergic rhinitis refractory to medical therapy.

Comparison of the Effectiveness and Safety of Radiofrequency Turbinoplasty and Traditional Surgical Technique in Treatment of Inferior Turbinate Hypertrophy

Inferior turbinate hypertrophy is one of the major causes of nasal airway obstruction. Medical treatment often produces insufficient improvements. In these cases, surgical reduction of inferior turbinates can be proposed. Many different techniques are currently available. We prospectively evaluate the safety and effectiveness of radiofrequency volumetric tissue reduction (RFVTR) compared with the traditional surgical technique. The study was conducted on 3 groups of 75 patients with symptoms and signs of nasal obstruction associated with inferior turbinate hypertrophy refractory to medical therapy. In group A, the turbinoplasty (TP) was performed using the classical surgical submucosal resection; in group B, the RFVTR was applied to inferior turbinate; and group C patients were not treated and served as control subjects. Nasal endoscopy, visual analogue scale (VAS), anterior active positional rhinomanometry, and saccharin tests were used to assess treatment outcomes at the end of week 1 and months 1 and 3 after surgery. Turbinate edema and secretions decreased significantly (P < 0.05) in groups A and B from 1 month after surgery. The secretions in group A increased temporarily on the seventh day after surgery. Concerning the nasal obstruction and related symptoms, significant improvement was observed at 1 month after treatment in all patients (P < 0.05) and continued up to 3 months after surgery (P < 0.0001). Rhinomanometric measurements demonstrated a significant nasal flow increase at 3 months (P < 0.0001). The nasal mucociliary transport time increased in group A at week 1. The difference among the 3 groups at month 1 was observed not significant. In this study, we demonstrated that both RFVTR and TP are effective in improving nasal obstruction and related nasal symptoms. In support of the RFVTR, different factors are important: it can be performed in local anaesthesia; it does not require a nasal package; it does not cause either a change of mucociliary function or an increase of secretions and crusts; and the patient can be discharged immediately after treatment. Therefore, we suggest that the RFVTR offers an efficient, gentle, and function-maintaining alternative to TP. However, because of the short follow-up, future investigations are needed for a more exhaustive evaluation of equivalency of the 2 turbinate procedures.