The efficacy of radiofrequency ablation technique in patients with inferior turbinate hypertrophy

Year 2008, Volume: 18 Issue: 2, 90 - 96, 18.04.2008

Beyazıt Yıldırım İsmail Önder Uysal Cahit Polat Cengiz Gök

Abstract

Objectives: The efficacy of the radiofrequency ablation technique was evaluated in patients with nasal airway obstruction due to inferior turbinate hypertrophy. Patients and Methods: The study included 30 patients 20 females, 10 males; mean age 32±12 years; range 17 to 18 years treated with radiofrequency ablation. The patients were evaluated preoperatively and at 3, 7, and 60 days for nasal obstruction, turbinate edema, and other complaints using a visual analog scale VAS . Nasal ciliary activity was evaluated by the saccharin test at 7 and 60 days, and nasal volume was measured by acoustic rhinometry at 60 days. Results: Postoperative VAS scores of nasal obstruction, nasal itching, crusting, sneezing, rhinolalia, nasal discharge, and post-nasal drip significantly decreased p<0.05 , while hyposmia score remained unchanged. Postoperative pain was trivial and did not require analgesic use. Nasal passage volume increased significantly p<0.05 . Nasal ciliary activity did not change significantly. No significant episodes of epistaxis were observed postoperatively. Conclusion: Radiofrequency ablation may be the treatment of choice for turbinate reduction because it is highly effective, minimally invasive with very low complication rates, and can be performed in outpatient clinics without general anesthesia.

Keywords

Catheter ablation, hypertrophy, nasal obstruction/surgery, turbinates /pathology/surgery

Alt konka hipertrofisi olan hastalarda radyofrekans tekniğinin etkinliği

Abstract

Amaç: Alt konka hipertrofisine bağlı burun tıkanıklığı yakınması olan hastalarda radyofrekans enerjisi ile ablasyon tekniğinin etkinliği araştırıldı.Hastalar ve Yöntemler: Çalışmaya radyofrekans ablasyon ile tedavi edilen 30 hasta alındı. Hastaların ameliyat öncesinde ve ameliyat sonrası 3, 7, ve 60. günlerde nazal obstrüksiyon/konka ödemi, ağrı ve diğer yakınmaları görsel analog skala ile değerlendirildi. Yedinci günde nazal siliyer aktiviteyi ölçmek amacıyla sakarin testi, 60. günde sakarin testi ve nazal volüm değerlendirmesi için akustik rinometri ölçümleri yapıldı.Bulgular: Ameliyat öncesine göre, koku alamama skoru dışında, hastaların burun tıkanıklığı, nazal kaşıntı, kabuklanma, hapşırma, rinolali, burun akıntısı, geniz akıntısı skorlarında anlamlı derecede azalma oldu p

Keywords

Kateter ablasyonu, hipertrofi, burun tıkanıklığı/cerrahi, turbinat/patoloji/cerrahi

References

• Rhee CS, Kim DY, Won TB, Lee HJ, Park SW, Kwon TY, et al. Changes of nasal function after temperature- controlled radiofrequency tissue volume reduction for the turbinate. Laryngoscope 2001;111:153-8.
• Li KK, Powell NB, Riley RW, Troell RJ, Guilleminault C. Radiofrequency volumetric tissue reduction for treatment of turbinate hypertrophy: a pilot study. Otolaryngol Head Neck Surg 1998;119:569-73.
• Erişen L. Obstrüktif uyku apnesi sendromu. In: Çelik O, editör. Kulak burun boğaz hastalıkları ve baş boyun cerrahisi. İstanbul: Turgut Yayıncılık; 2002. p. 964-84.
• Hol MK, Huizing EH. Treatment of inferior turbinate pathology: a review and critical evaluation of the dif- ferent techniques. Rinology 2000;38:157-66.
• Utley DS, Goode RL, Hakim I. Radiofrequency energy tissue ablation for the treatment of nasal obstruction sec- ondary to turbinate hypertrophy. Laryngoscope 1999; 109:683-6.
• Coste A, Yona L, Blumen M, Louis B, Zerah F, Rugina M, et al. Radiofrequency is a safe and effective treat- ment of turbinate hypertrophy. Laryngoscope 2001;111: 894-9.
• Back LJ, Hytonen ML, Malmberg HO, Ylikoski JS. Submucosal bipolar radiofrequency thermal ablation of inferior turbinates: a long-term follow-up with sub- jective and objective assessment. Laryngoscope 2002; 112:1806-12.
• Archer SM. Turbinate dysfunction. Available from: http://www.emedicine.com/ent/topic129.htm
• Seeger J, Zenev E, Gundlach P, Stein T, Muller G. Bipolar radiofrequency-induced thermotherapy of turbinate hypertrophy: pilot study and 20 months’ follow-up. Laryngoscope 2003;113:130-5.
• Bhattacharyya N, Kepnes LJ. Clinical effectiveness of coblation inferior turbinate reduction. Otolaryngol Head Neck Surg 2003;129:365-71.
• Fischer Y, Gosepath J, Amedee RG, Mann WJ. Radiofrequency volumetric tissue reduction [RFVTR] of inferior turbinates: a new method in the treatment of chronic nasal obstruction. Am J Rinol 2000;14:355-60.
• Sapci 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.
• Passali D, Lauriello M, Anselmi M, Bellussi L. Treatment of hypertrophy of the inferior turbinate: long-term results in 382 patients randomly assigned to therapy. Ann Otol Rinol Laryngol 1999;108:569-75.
• Salam MA, Wengraf C. Concho-antropexy or total inferior turbinectomy for hypertrophy of the infe- rior turbinates? A prospective randomized study. J Laryngol Otol 1993;107:1125-8.
• Illum P. Septoplasty and compensatory inferior tur- binate hypertrophy: long-term results after random- ized turbinoplasty. Eur Arch Otorinolaryngol 1997;254 Suppl 1:S89-92.
• Fradis M, Golz A, Danino J, Gershinski M, Goldsher M, Gaitini L, et al. Inferior turbinectomy versus sub- mucosal diathermy for inferior turbinate hypertrophy. Ann Otol Rinol Laryngol 2000;109:1040-5.
• Rakover Y, Rosen G. A comparison of partial inferior turbinectomy and cryosurgery for hypertrophic infe- rior turbinates. J Laryngol Otol 1996;110:732-5.
• Lagerholm S, Harsten G, Emgård P, Olsson B. Laser- turbinectomy: long-term results. J Laryngol Otol 1999;113: 529-31.
• Ottaviani F, Capaccio P, Cesana BM, Manzo R, Peri A. Argon plasma coagulation in the treatment of nonal- lergic hypertrophic inferior nasal turbinates. Am J Otolaryngol 2003;24:306-10.
• Van Delden MR, Cook PR, Davis WE. Endoscopic partial inferior turbinoplasty. Otolaryngol Head Neck Surg 1999;121:406-9.
• Smith TL, Correa AJ, Kuo T, Reinisch L. Radiofrequency tissue ablation of the inferior turbinates using a ther- mocouple feedback electrode. Laryngoscope 1999; 109:1760-5.