Comparison of the effectiveness and safety of radiofrequency
turbinoplasty and traditional surgical technique in treatment of
inferior turbinate hypertrophy.Cavaliere M, Mottola G, Iemma M.
Department of Otorhinolaryngology, Moscati Hospital, Avellino, Italy.
matorl@inwind.it

OBJECTIVES: 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. METHODS: 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.
RESULTS: 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. CONCLUSION: 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.

PMID: 16360523 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=R
etrieve&dopt=abstractplus&list_uids=16585858

Long-term results of inferior turbinate hypertrophy with
radiofrequency treatment: a new standard of care?Porter MW, Hales NW,
Nease CJ, Krempl GA.
Department of Otorhinolaryngology, University of Oklahoma Health
Sciences Center, Oklahoma City, Oklahoma, USA.

OBJECTIVE: The objective of this study was to report the long-term
efficacy of radiofrequency volumetric tissue reduction (RFVTR) and to
compare this with other accepted surgical treatments of inferior
turbinate hypertrophy. STUDY DESIGN AND SETTING: Prospective, 2-year
follow-up of 19 patients originally enrolled in a prospective,
randomized, single blinded, placebo controlled trial for treatment of
inferior turbinate hypertrophy with RFVTR. Patients evaluated their
severity of obstruction, frequency of obstruction, and overall ability
to breathe by way of a 10 cm visual analogue scale. RESULTS: RFVTR for
inferior turbinate hypertrophy showed continued benefit at 2 years
posttreatment, with no indication of increasing symptomatology. The
benefit demonstrated in frequency of obstruction, severity of
obstruction, and overall ability to breathe (P < .05) was maintained
at 2 years. No complications occurred. Review of the literature shows
lower short- and long-term complications for RFVTR compared with other
surgical methods CONCLUSION: RFVTR is effective in treating inferior
turbinate hypertrophy with sustained benefit at 2 years follow-up
while resulting in fewer complications than other surgical methods.
Significance: RFVTR is a relatively new procedure, and therefore there
are few long-term evaluations of its effectiveness; this is the first
prospective study to document successful outcomes at 2 years follow-
up.

PMID: 16585858 [PubMed - indexed for MEDLINE]

Isn't somnoplasty a treatment for sleep troubles - notably sleeping
loudly? Radioablation sounds interesting, I'll mention it to my ENT on
our next visit. I'm not sure of the term for the surgery he has
already suggested, another question for next time, but it's purpose
was to correct the deviated septum and shave some off the "enlarged
turbinate."

Heh, yesm - that was me. That actually had to do with an allergic
reaction that I thought I was having to Cipro, and I stopped taking it
after about a week. It was also around that time that the lethargy was
rendering me mostly useless...

I've been thinking about this throughout my recent coughing fits...I'm
going to have to go with the chest as its origin.

Still going strong, often times worse at certain times of the day. An
example would be shortly after work (past 5pm), and then improving
after dinner and such. It was my thought that getting some food/drink
down "cleans the pipes," if only temporarily.

I've had similar hopes, and it's one possibility I'm counting in favor
of the surgery. However the surgery suggested, as I understand it,
doesn't even enter the sinus cavities, and so I suppose wouldn't allow
for such a chance encounter... Also of note is that the Radiology
report actually showed "mild left maxillary sinus disease," but my ENT
implied that it was negligible, and he probably won't attempt to do
anything about it.

It's also my understanding that a deviated septum causes frequent
sinus infections. So, I'm hoping that even if the infection itself
isn't showing up on the CT's, and isn't taken out via surgery, it will
clear up once the structural problems have been corrected. Is this a
reasonable thought?

Thanks for the feedback!