Radiofrequency Volumetric Tissue Reduction Research Articles

Radiofrequency Coblation versus Surface Bipolar Cautarization for the Treatment of Inferior Turbinate Hypertrophy

Background: Nasal obstruction is the foremost complaint of a large number of patients in otolaryngologic practice most commonly caused by inferior turbinate hypertrophy. Objective: This study aimed to compare surface bipolar electrocautery with radiofrequency coblation in the treatment of inferior turbinate hypertrophy. Patients and Methods: This clinical trial study was conducted at ENT Department, Faculty of Medicine, Zagazig University Hospitals in the period from May 2020 to Jul 2021, included 34 patients with nasal obstruction due to hypertrophied inferior turbinates (HIT) resistant to medical treatment for a period not less than six weeks. The first group included 17 patients with HIT treated by bipolar cauterization and second group include 17 patients with HIT treated by radiofrequency coblation. Results: This study showed that nasal obstruction showed significant improvement in both groups postoperatively. There was no significant deference between both regarding nasal obstruction although there was improvement in objective evaluation. In addition, there was no crustation observed in nasal mucosa among patient. The discharge and crustation were significantly associated with bipolar group. Conclusions: Both techniques have proven to be equally effective. In both the groups, radiofrequency is considered to be more accurate. Bipolar electrocautery and radiofrequency volumetric tissue reduction are equally effective in improving both the subjective and objective nasal obstruction.

A Study on Radiofrequency volumetric tissue reduction of hypertrophied inferior turbinate in chronic nasal obstruction patients

A Study on Radiofrequency volumetric tissue reduction of hypertrophied inferior turbinate in chronic nasal obstruction patients

Inferior Turbinate Hypertrophy: A Review of the Evolution of Management in Children.

Historically, there has been uncertainty in the treatment of inferior turbinate hypertrophy (ITH) in children. Although management always begins with medical therapy, the decision to offer surgery in resistant cases is becoming more widely practiced. In the pediatric population, turbinate reduction can be achieved with turbinectomy, electrocautery, lasers, submucous microdebridement, and radiofrequency volumetric tissue reduction (RVTR). However, there remains a lack of consensus on the preferred approach to treatment. To compare how the efficacy, duration, and complications of different surgical methods has changed the management of inferior turbinate hypertrophy in children over time. In March 2018, a comprehensive literature search was performed in PubMed for all inferior turbinate hypertrophy management-related studies in children. Inclusion criteria included children (age, 1-17 years). Exclusion criteria included reviews and abstracts. Each technique has experienced a period of popularity over the last 30 years in parallel with the technology available at the time as well as evidence from studies in adults. The literature for ITH management in children has largely followed these trends, with a recent improvement in the quality of studies mirroring the overall increase in surgical practice. Of all methods currently used, RVTR and submucous microdebridement offer the least invasive and most efficacious relief of nasal obstruction. This review provides an overview of the evolution of ITH management in children and, based on historic and current evidence, proposes the following graduated recommendation to treatment: (1) a 3-month trial of medical management, (2) evaluation for adenoid hypertrophy for consideration of concurrent adenoidectomy, and (3) RVTR or submucous microdebridement as the first-line surgical approach.

Radiofrequency volumetric inferior turbinate reduction: long-term clinical results.

SUMMARYThe aim of our study was to assess long-term results of radiofrequency volumetric tissue reduction of inferior turbinates (RVTR). We performed a prospective long-term longitudinal evaluation of 305 patients affected by rhinitis (114 allergic and 191 non-allergic) who were unresponsive to medical treatment and underwent RVTR (January 2004 - December 2010). Subjects were followed for a mean period of 39.70 ± 19.41 months (range 24-60). Patients completed the NOSE-scale questionnaire pre- and post-operatively after 1 month and yearly for 5-years. Recurrence was assumed if the post-operative total NOSE score increased by at least 75% during follow-up and the patient restarted medical treatments. Estimation of relapse over time was performed by Kaplan-Meyer analyses. We documented overall good satisfaction of patients regarding the procedure, with a good rate of pain control and a low rate of complications. Post-operatively there was a significant improvement in nasal stuffiness, nasal obstruction and mouth breathing (p < 0.05). We observed a worsening trend for symptoms after 36 months with progressive increasing rate of recurrences that were significantly higher in allergic than non-allergic patients (p < 0.05). We also observed a slight worsening trend of global satisfaction of patients. Our study confirms the minor discomfort and low risk of side effects of RVTR. Our data showed good efficacy of the procedure in the majority of patients for at least 36 months after surgery, and in fact in this time period the cumulative probability to remain relapse-free was up to 0.8. In the following 2 years, we observed a worse temporal trend in term of recurrence rate, and in particular in allergic patients with a significant difference vs non-allergic individuals (p < 0.05).

Ablation‐Assisted Uvulapalatopharyngoplasty Technique for OSAS Treatment: A 5‐Year Follow‐up Study

Objectives: Determine the long-term outcome of patients suffering from obstructive sleep apnea syndrome (OSAS) treated by ablation-assisted uvulapalatopharyngoplasty. Methods: Seventy-five subjects were included between 2005 and 2007. All patients suffered from moderate or severe OSAS. They were treated by radiofrequency volumetric tissue reduction (RFVTR) of the palatopharyngeal abnormal tissues (including tonsillar RFVTR or tonsillectomy), the advance of palatopharyngeal arch after the dissection of palatopharyngeal vault, and the inferior one-third of the palatine velum interspace. Polysomno-graphy (PSG), snoring (assessed on a 10cm visual analog scale [VAS]), marital status, and presence of cardiovascular risk factors or pathologies were evaluated by postal questionnaire. Results: Mean follow-up time was 5.3 ± 1.3 years. Mean snoring intensity decreased significantly in the immediate postoperative period (8.1 ± 2.9 to 3.5 ± 2.2 cm on VAS). Over the longer term, however, we observed a slight increase in snoring intensity (3.7 ± 2.9 cm) ( P &gt; .05). PSG monitoring, RDN (344 ± 38), apnea-hypopnea index (AHI; 59 ± 10), obstructive sleep apnea time (OSAT) (35 ± 13)s, longest obstructive apnea time (LOSAT) (87 ± 26)s, and the mean arterial pressure (145 ± 14) mm Hg in OSAS decreased significantly in the immediate postoperative period ( P &lt; .01). Over the longer term, however, we observed a slight increase in PSG monitoring result ( P &gt; .05) but still better than before surgery ( P &lt; .01). Hypertension and diabetes were diagnosed during follow-up in 12.1% and 6.6% of the subjects, respectively. A minority of patients failed to undergo repeat polysomnography. Conclusions: Ablation-assisted uvulapalatopharyngoplasty is highly effective in the treatment of OSAS. Expected scar formation, enlarged nasopharyngeal and oropharyngeal cavity, reduction of the uvula and lateral pharyngeal bands may contribute to these good success rates.

EMLA® cream as local anesthetic for radiofrequency turbinate tissue reduction

Radiofrequency volumetric tissue reduction is a minimally invasive technique in the treatment of turbinate hypertrophy and is generally performed under local anesthesia. However, perioperative discomfort and pain are common side effects and studies concerning the technique of choice to anesthetize the nasal mucosa in this procedure are lacking. The aim of this prospective controlled trial is to assess the effectiveness of EMLA(®) cream as a topical anesthetic for radiofrequency volumetric tissue reduction of inferior turbinates comparing its effect with that obtained using a traditional anesthetic technique. 200 consecutive patients undergoing volumetric tissue reduction with topical anesthesia were enrolled. Patients were divided into two groups: Group A included 100 patients treated by placing cotton pledgets soaked with lidocaine 10% in the inferior meatus followed by the injection of 2% lidocaine into the head of the inferior turbinate; Group B included 100 patients treated with EMLA(®) cream. Patients were evaluated before and after surgery using rhinomanometry for obstructive symptoms. Four VAS about pain, troublesome swallowing, choking sensation and intraoperative anxiety were submitted to each patient immediately after surgery and after 2 months to assess various aspects of perioperative discomfort. A significant increase of nasal airflow was observed without differences between the two groups. Subjective evaluation regarding perioperative discomfort showed significant differences between Groups A and B immediately after surgery although it was less pronounced 2 months later. The results of this study suggest that EMLA(®) cream is an efficient tool in obtaining an adequate anesthetic effect in this procedure.

Combined radiofrequency volumetric tissue reduction and lateral outfracture of hypertrophic inferior turbinate in the treatment of chronic rhinitis: short‐term and long‐term outcome

Radiofrequency volumetric tissue reduction (RFVTR) of hypertrophic inferior turbinate (IT) is an effective way to treat patients with intractable nasal mucosal obstruction. We evaluated the effectiveness of combined RFVTR and lateral outfracture (LO) of hypertrophic IT in chronic rhinitis (CR) patients on reduction of nasal obstruction, rhinorrhea, and nasal pruritus both short and long term. Seventy-three patients with CR who failed medical treatment were recruited to undergo combined RFVTR and LO of hypertrophic IT. Nasal congestion scores were recorded before the operation, and immediately, 2 weeks, 6 weeks, 3 months, 6 months, 1 year, 2 years, and 3 years after the operation. Rhinorrhea and pruritic score as well as total nasal airway resistance (TNAR) and total nasal airflow (TNAF) (measured by active anterior rhinomanometry) were recorded before the operation, and 2 weeks, 6 weeks, 3 months, 6 months, 1 year, 2 years, and 3 years after the operation. Forty-five patients completed the follow-up period of 3 years. Subjects consisted of 25 male and 20 female patients, with an average age of 31 years. Nasal congestion scores were significantly improved immediately after the operation. Nasal congestion scores and TNAR values were significantly decreased whereas TNAF values were significantly increased at every time point postoperatively. Rhinorrhea and pruritic scores were also significantly improved at every time point after 2 weeks postoperatively. Combined RFVTR and LO of hypertrophic IT is an effective treatment for nasal obstruction, rhinorrhea, and nasal pruritus in CR and the result lasts up to 3 years postoperatively.

EMLA Cream as Local Anesthetic for Endoscopic Radiofrequency Volumetric Inferior Turbinate Tissue Reduction

Objectives: Radiofrequency volumetric tissue reduction (RFVTR) is usually performed under local anesthesia. Although this is a simple procedure, patients often report perioperative discomfort. The aim of this prospective study was to determine the effectiveness of Lidocaine/prilocaine eutectic mixture (EMLATM cream) as a topical anesthetic for RFVTR. A comparison between EMLATM cream and lidocaine 10% in liquid formulation has also been made. Methods: 200 consecutive patients undergoing RFVTR with topical anesthesia were enrolled in this randomized controlled trial from March 2010 to March 2012. The patients were divided into 2 groups: Group A included 100 patients treated with cotton pledgets soaked with lidocaine 10%, and Group B included 100 patients treated with EMLATM cream. Patients were evaluated before and after surgery using endoscopy and rhinomanometry. Four 10 cm Visual Analogue Scale (VAS) were submitted to each patient immediately after surgery and after 2 months to assess various aspects of perioperative discomfort. Results: A significant increase of nasal airflow and a subjective improvement of symptoms were observed without differences between the 2 groups. Subjective evaluation regarding perioperative discomfort showed a significant difference between Group A and Group B immediately after surgery and a slight but not significant difference after 2 months. Conclusions: RFVTR is an effective technique in the treatment of turbinate hypertrophy. The unintentional passage of anesthetic liquid into the pharynx is likely the cause of greater discomfort. The higher viscosity of the EMLATM cream provides greater permanence on the nasal mucosa and a more effective anesthesia.

The Potential Role of Hyaluronic Acid in Postoperative Radiofrequency Surgery for Chronic Inferior Turbinate Hypertrophy

We prospectively evaluated the efficacy of hyaluronic acid (HA) as an adjuvant treatment to hasten the improvement of nasal respiration and to minimize patients' discomfort in the postoperative radiofrequency volumetric tissue reduction (RFVTR) of inferior turbinates. We enrolled 57 patients randomly assigned into two groups, HA (22 patients) and saline group (35 patients), which received isotonic saline nasal irrigation. We used the monopolar device somnoplasty for all patients. Visual analogic scale (VAS) and nasal endoscopy were used to assess the outcomes of the treatments during the 1st month of follow-up. The mean VAS score of the HA group at the 1st week was significantly lower than the control group (3.36 ± 1.89 versus 6.95 ± 1.52; p < 0.05). The VAS score remained significantly lower in the HA group also at the 2nd week (3.43 ± 1.27 versus 5.75±1.39; p < 0.05), becoming similar to the control group at the 4th week (p = ns). Since the first visit the HA group also showed significantly lower crust score than the saline group (p < 0.05), and there was no crust found in either group at the last visit. The compliance to treatment was similar in both groups. The results of this prospective study suggest a role of HA as a supportive treatment for faster improvement of nasal respiration, also minimizing patients' discomfort in postoperative nasal surgery, promoting nasal mucosa healing in postoperative RFVTR for inferior turbinate hypertrophy.

Postnasal Drip due to Inferior Turbinate Perforation after Radiofrequency Turbinate Surgery: A Case Report

Management of inferior turbinate hypertrophy includes surgical options in case of failure with medical treatment and the main goal of turbinate surgery is to relieve the patient's symptoms of chronic nasal congestion while preserving mucosal surfaces with reduction of the submucosal and bony tissue. In this regard, radiofrequency volumetric tissue reduction has been a thermal technique associated with satisfactory results and fewer side effects. Historical detail on onset, timing, duration, and severity of symptoms and aggravating and relieving factors are important in the differential diagnosis of postnasal drip (PND). Here, we report development of intractable PND due to inferior turbinate perforation after radiofrequency turbinate surgery for the first time in the literature and the successful improvement via removal of pathological anatomic structure under nasal endoscopy–directed surgery in a 35-year-old female patient. The patient had a good functional outcome postoperatively with no further complications or signs of recurrence occurring, to date, within a postoperative follow-up period of 1 year.

Tongue coblation via the ventral approach for obstructive sleep apnea–hypopnea syndrome surgery

To determine the safety and efficacy of tongue Coblation via the ventral approach in the treatment of hypopharyngeal obstruction for patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Prospective case-control study. Tongue Coblation was performed under local anesthesia in one session in 40 inpatients diagnosed with OSAHS with predominant hypopharyngeal obstruction after failed uvulopalatopharyngoplasty. In the ventral approach (n = 20), only one puncture point was applied at the center of lingual frenulum, and 12 radiofrequency volumetric tissue reduction (RFVTR) lesions were implanted in the tongue. In the dorsal approach (n = 20), eight RFVTR lesions were distributed on the tongue. Using portable polysomnography (PSG) and the Epworth sleepiness questionnaire (ESQ), we followed 36 patients for 1 year after the operation. Good outcome was defined as apnea-hypopnea index <20 or reduction >50%. In the ventral approach, total energy was accumulated to 23,000 J in 12 lesions, with postoperative pain 2-3 by visual analog scale (VAS). There was only one case of moderate venous bleeding and hematoma. The ESQ comparison indicated subjective improvements in patients, and PSG showed a curative effect in 11 of 19 (61.11%, eight of 19 success plus three of 19 responders), with a failure rate of eight of 19. By contrast, in the dorsal approach, total energy was 16,000 J, with postoperative pain 3-4 (VAS). Complications included mild to moderate tongue venous hematoma, severe infection of tongue, and temporary mild glossal deviation. A curative effect was seen in six of 17, with a failure rate of 11 of 17. Tongue Coblation via the ventral approach is an effective and safe technique to treat hypopharyngeal obstruction in OSAHS surgery.

Bipolar radiofrequency volumetric tissue reduction of the inferior turbinates: evaluation of short-term efficacy in a prospective, randomized, single-blinded, placebo-controlled crossover trial

The objective of the study was to assess the short-term efficacy of radiofrequency volumetric tissue reduction (RFVTR) of the inferior turbinates in patients with nasal obstruction caused by turbinate hypertrophy. The study is a prospective, randomized, single-blinded, placebo-controlled, crossover trial. A total of 22 patients (age range 21-72 years; median age 41 years) were randomized into two treatment arms. Using a bipolar radiofrequency system, the first group (VP-group) received RFVTR (verum = V) first (at t1) followed by a placebo treatment (P) 6-8 weeks later (at t2). The PV-group was treated with placebo first at t1 and received RFVTR at t2. Subjects in both groups underwent identical procedures in an office-based setting. Delivery of radiofrequency energy was the only difference between the two groups. The outcome measures assessed were rhinomanometry, physician's evaluation of the degree of hypertrophy of the inferior turbinates and patients' estimation of nasal obstruction. Physician and patient evaluations were documented using a score ranging from 0 = none to 4 = severe. Evaluation was performed 6-8 weeks after every intervention. No intraoperative or postoperative complications occurred. Inferior turbinate hypertrophy improved significantly in both groups after RFVTR was performed (VP-group: p < 0.001; PV-group: p = 0.002). Nasal obstruction also decreased only after RFVTR (VP-group: p = 0.004, PV-group: p = 0.002). This study confirmed the safety of bipolar RFVTR as an office-based treatment of nasal obstruction due to inferior turbinate hypertrophy. We could prove that RFVTR is superior to placebo for reduction in turbinate hypertrophy and subjective improvement in nasal obstruction. To our knowledge, this is the first level I study proving the short-term efficacy of a bipolar radiofrequency system.

Radiofrequency volumetric tissue reduction of the inferior turbinate in a sheep model

To validate the sheep model for endoscopic nasal surgery, and to utilize this model to compare the immediate and early postoperative histopathologic effects of four electrosurgical turbinate reduction techniques. Pilot comparative study of electrosurgical devices for inferior turbinate reduction using a sheep model. Three radiofrequency devices (one monopolar and two bipolar) were compared to monopolar electrosurgery in a sheep model of inferior turbinate reduction. Procedures were performed according to device manufacturer guidelines using standard endoscopic instruments. Normative acoustic rhinometry data were obtained for the sheep model. Histopathologic analysis of turbinate specimens was performed at postoperative day 0 and 21. Turbinate reduction was performed on seven sheep, one procedure on each side, yielding 14 turbinate specimens. Acoustic rhinometry was validated in the sheep model and demonstrated increased nasal volumes following decongestion and turbinate reduction. Submucosal destruction of glands and venous sinusoids and replacement with fibrosis were demonstrated as a common mechanism of action for all four electrosurgical devices. Epithelial disruption was seen with all devices on postoperative day 0. Squamous metaplasia and normal respiratory epithelial regeneration were documented variably between devices at postoperative day 21. The sheep model is useful for study of both the anatomic and histopathologic effects of endonasal procedures. Standard endoscopic instruments and acoustic rhinometry can be used in this model with reproducible results. In this pilot animal study, radiofrequency devices for inferior turbinate reduction demonstrated greater preservation of normal nasal mucosal respiratory epithelium when compared to monopolar electrosurgery.

Quantitative measurement of radiofrequency volumetric tissue reduction by multidetector CT in patients with inferior turbinate hypertrophy

To objectively assess the efficacy of radiofrequency thermal ablation of inferior turbinate hypertrophy. Thirty-five patients with nasal obstruction secondary to inferior turbinate hypertrophy were prospectively enrolled. Radiofrequency energy was delivered to four sites in each inferior turbinate. Patients were evaluated before and 8 weeks after intervention. Subjective evaluation of nasal obstruction was performed using a visual analogue scale (VAS), and objective evaluation of the turbinate volume reduction was calculated using multidetector CT. Volumetric measurements of the preoperative inferior turbinate were compared with postoperative values on both sides. The great majority of patients (91.4%) exhibited subjective postoperative improvement. Mean obstruction (VAS) improved significantly from 7.45±1.48 to 3.54±1.96. Significant turbinate volume reduction was achieved by the surgery on both right and left sides [(preoperative vs. postoperative, right: 6.55±1.62cm(3) vs. 5.10±1.47cm(3), (P<0.01); left: 6.72±1.53cm(3) vs. 5.00±1.37cm(3), (P<0.01)] respectively. Radiofrequency is a safe and effective surgical procedure in reducing turbinate volume in patients with inferior turbinate hypertrophy. Multidetector CT is an objective method of assessment in detecting radiofrequency turbinate volume reduction.

Radiological Appearances of Oropharyngeal Soft Tissue Reduction with Bipolar Radio-Frequency Ablation in Sleep Disordered Breathing

To demonstrate and track the changes of bipolar radiofrequency volumetric tissue reduction (BRFVTR) induced lesions of the tongue base and soft palate in the treatment of sleep disordered breathing (SDB) in a pilot study.

The efficacy of radiofrequency volumetric tissue reduction of hypertrophied inferior turbinate in allergic rhinitis

To evaluate the efficacy of radiofrequency volumetric tissue reduction (RFVTR) technique in treatment of allergic inferior turbinate hypertrophy (ITH) and to study its effect on nasal mucociliary clearance. This prospective study was conducted over 50 perenial allergic rhinitis patients with persistent nasal obstruction due to bilateral ITH refractory to medical management received one time RFVTR of both inferior turbinates. Symptoms were subjectively assessed by Visual Analog Scale (VAS) and mucociliary clearance was measured by saccharin transit time (STT) pre-operatively, at 1 week, 1, 3, and 6 months post-operatively. Forty-seven subjects completed study. All patients had significant symptomatic improvement which started from 1 week post-operatively and persisted up to 3 months. Post-operative VAS scores of nasal obstruction, rhinorrhea, sneezing, headache, and snoring at 1 week 1, 3 and 6 month follow up visits significantly decreased (P < 0.05) whereas significant decreased in post-operative VAS scores of hyposmia was observed at 1 month follow up (P < 0.05). Though increase in VAS scores was observed during 6 month follow up, the difference between pre-operative and 6 month post-operative mean VAS score was statistically significant (P < 0.05). Symptomatic improvement in nasal obstruction, rhinorrhea, sneezing, headache, hyposmia, and snoring persisted in 89.4%, 95.6%, 97.8%, 88.5%, 46.7%, and 100% of patients, respectively, during 6 month follow up. There was no significant change in STT following RFVTR except at 1 week follow up (P < 0.0001). RFVTR is safe and effective in treatment of ITH in allergic rhinitis patients.

Radiofrequency Volumetric Tissue Reduction of the Inferior Turbinate in a Sheep Model

Radiofrequency Volumetric Tissue Reduction of the Inferior Turbinate in a Sheep Model

Radiological airway changes following bipolar radiofrequency volumetric tissue reduction

To characterise the appearance of lesions of the tongue base and soft palate induced by bipolar radiofrequency volumetric tissue reduction, using magnetic resonance imaging up to six weeks post-procedure. Five men with sleep-disordered breathing were treated with one session of bipolar radiofrequency volumetric tissue reduction to a number of sites, including the tongue base and soft palate. Magnetic resonance imaging was performed pre-operatively and one week and six weeks after surgery. Lesions were visible from day one. T1 (spine lattice relaxation Time)-weighted images demonstrated areas of central hyperintensity, reflecting haemorrhagic, coagulative necrosis, surrounded by hypointensity, representing oedema; corresponding short tau inversion recovery (STIR) sequences showed central hypointensity with surrounding high signal. The lesions expanded up to day three and then gradually diminished, but were still evident at week six on short tau inversion recovery images. The characterisation of lesions induced by bipolar radiofrequency volumetric tissue reduction enables us to elucidate the pathophysiology of this procedure, to optimise treatment benefits and clinical outcomes, and to explain patient symptoms.

「睡眠障害をめぐって」睡眠呼吸障害（ＳＤＢ）の外科的治療

Among sleep disorders of breathing (SDB), obstructive sleep apnea syndrome (OSAS) sometimes indicates the need for surgical treatment. Despite the use of uvulopalatopharyngoplasty (UPPP), which has been mainly utilized to date, it has become clear that diet control is also necessary to prevent recurrence of the symptoms. Other recent operative methods, including laser assisted uvulopalatoplasty (LAUP), radiofrequency volumetric tissue reduction (RFVTR), etc., have not yet revealed their detailed outcome and prognosis. However, the combined procedures of pharyngeal surgery and nasal surgery could be valuable. In order to achieve a better outcome, three points appear to be necessary for surgical strategy for OSAS; 1) To diagnose the precise obstructive portion and select appropriate cases for the indication to improve both the pharyngeal and nasal obstruction, 2) To reduce the body weight and maintain diet control, 3) To reduce the risk factors of surgical side effects and negative social medical factors.

Effect of the Radiofrequency Volumetric Tissue Reduction of Inferior Turbinate on Expiratory Nasal Sound Frequency

We sought to evaluate the short-term efficacy of radiofrequency volumetric tissue reduction (RFVTR) in treatment of inferior turbinate hypertrophy (TH) as measured by expiratory nasal sound spectra. In our study, we aimed to investigate the Odiosoft-rhino (OR) as a new diagnostic method to evaluate the nasal airflow of patients before and after RFVTR. In this study, we have analyzed and recorded the expiratory nasal sound in patients with inferior TH before and after RFVTR. This analysis includes the time expanded waveform, the spectral analysis with time averaged fast Fourier transform (FFT), and the waveform analysis of nasal sound. We found an increase in sound intensity at high frequency (Hf) in the sound analyses of the patients before RFVTR and a decrease in sound intensity at Hf was found in patients after RFVTR. This study indicates that RFVTR is an effective procedure to improve nasal airflow in the patients with nasal obstruction with inferior TH. We found significant decreases in the sound intensity level at Hf in the sound spectra after RFVTR. The OR results from the 2000- to 4000-Hz frequency (Hf) interval may be more useful in assessing patients with nasal obstruction than other frequency intervals. OR may be used as a noninvasive diagnostic tool to evaluate the nasal airflow.