Title: A Study on Radiofrequency volumetric tissue reduction of hypertrophied inferior turbinate in chronic nasal obstruction patients
Authors: Ashok Sharma, Pulkit Khandelwal, Meenakshi Mehra, Madhurima Baneerjee, Vivek Taneja
DOI: https://dx.doi.org/10.18535/jmscr/v7i3.237
Abstract
To assess the treatment of hypertrophy of inferior turbinates in patients with chronic nasal obstruction with the use of radiofrequency volumetric tissue reduction technique. Ablation with radiofrequency was used in this study on the inferior turbinates of 240 patients with chronic nasal obstruction at our hospital between December 2015 and December 2017. The results were evaluated subjectively by changes in pre and post-operative symptoms, size of inferior turbinate, postoperative pain and assessment of Eustachian tube function by looking at retraction of tympanic membrane. In our study nasal obstruction, nasal discharge, sneezing, snoring, hyposmia improved in 86%, 93%, 90.2%, 33%, 60% respectively at the end of 1 month and symptoms further improved to 95 %, 100%, 90%, 91%, 100% at the end of 1 year. Similarly 35 % patients showed reduction in turbinate in first 7 days and 80 % of the reduction of inferior turbinate took place at the end of 1 month. Further improvement was seen at the end of 3 month, approximately 95 % patients showed reduction of inferior turbinate. And no significant difference was seen between 6 month and 12 months. Post-operatively 80% of patients with grade 1 and grade 2 tympanic membrane retractions showed improvement. On the contrary no improvement was seen in patients with grade 3 and 4 retractions.
These results suggests that radiofrequency volumetric tissue reduction of inferior turbinate is an easily applied, efficient and reliable technique in the treatment of hypertrophied inferior turbinate in chronic nasal obstruction patients.
Keywords: Radiofrequency ablation, inferior turbinate, tympanic membrane retraction, nasal obstrcution.
References
- Lippert BM, Werner JA (1996) Nd: YAG laser light-induced reduction of nasal turbinates. Laryngorhinootologie 75:523–528
- Ottaviani F, Capaccio P, Cesana BM et al (2003) Argon plasma coagulation in the treatment of nonallergic hypertrophic inferior nasal turbinates. Am J Otolaryngol 24:306–310
- Elwany S, Gaimaee R, Fattah HA. Radiofrequency bipolar submucosal diathermy of the inferior turbinates. Am J Rhinol 1999;13:145-9.
- Sapçi T, Sahin B, Karavus A, Akbulut UG. Comparison of the effects of radiofrequency tissue ablation, CO2 laser ablation, and partial turbinectomy applications on nasal mucociliary functions. Laryngoscope 2003;113:514-9.
- Sapci T, Sahin B, Karavus A et al (2003) Comparison of the effects of radiofrequency tissue ablation, CO2 laser ablation, and partial turbinectomy applications on nasal mucociliary functions. Laryngoscope 103:514–519
- Elwany S, Gaimaee R, Fattah HA (1999) Radiofrequency bipolar submucosal diathermy of the inferior turbinates. Am J Rhinol 13:145–149
- Smith TL, Correa AJ, Kuo T et al (1999) Radiofrequency tissue ablation of the inferior turbinates using a thermocouple feedback electrode. Laryngoscope 109:1760–1775
- Rhee CS, Kim DY, Won TB et al (2001) Changes of nasal function after temperature-controlled radiofrequency tissue volume reduction for the turbinate. Laryngoscope 111:153–158
- Elwany S, Gaimaee R, Fattah HA. Radiofrequency bipolar submucosal diathermy of the inferior turbinates. Am J Rhinol 1999;13:145-9.
- Utley DS, Goode RL, Hakim I. Radiofrequency energy tissue ablation for the treatment of nasal obstruction secondary to turbinate hypertrophy. Laryngoscope 1999;109:683-6.
- Sapci T, Usta C, Evcimik MF, Bozkurt Z, Aygun E, Karavus A, et al. Evaluation of radiofrequency thermal ablation results in inferior turbinate hypertrophies by magnetic resonance imaging. Laryngoscope 2007;117:623-7.
- Powell NB, Riley RW, Troell RJ, Li K, Blumen MB, Guilleminault C. Radiofrequency volumetric tissue reduction of the palate in subjects with sleep-disordered breathing. Chest 1998;113:1163-74.
- Hytönen ML, Bäck LJ, Malmivaara AV, Roine RP. Radiofrequency thermal ablation for patients with nasal symptoms: a systematic review of effectiveness and complications. Eur Arch Otorhinolaryngol 2009;266:1257-66.
- Smith TL, Correa AJ, Kuo T, Reinisch L (1999) Radiofrequency tissue ablation of the inferior turbinates using a thermocouple feedback electrode. Laryngoscope 109:1760–1765
- Parida PK1, Santhosh K, Ganesan S, Surianarayanan G, Saxena SK. (2011) The efficacy of radiofrequency volumetric tissue reduction of hypertrophied inferior turbinate in allergic rhinitis. Indian J Med Sci.2011 Jul;65(7):269-77. doi: 10.4103/0019-5359.107387.