Comparison of the effects of radiofrequency ablation and microdebrider reduction on nasal physiology in lower turbinate surgery

Yıl 2016, Cilt: 26 Sayı: 6, 325 - 332, 22.12.2016

Arda Pelen Muhammet Tekin Gül Özbilen Acar Osman İlkay Özdamar

Öz

Objectives: This study aims to compare the effects of radiofrequency ablation and microdebrider reduction in lower turbinate surgery on nasal physiology. Patients and Methods: Between January 2009 and March 2010, 40 patients with the complaint of nasal obstruction, who were diagnosed with lower turbinate hypertrophy, were randomly assigned into two groups to undergo either radiofrequency group 1, n=20 or microdebrider group 2, n=20 treatments. Nasal obstruction, the grade of turbinate hypertrophy and other symptoms were evaluated with subjective nasal obstruction scale and anterior rhinoscopy before the operation, and three days, seven days, four weeks, and eight weeks after the surgical intervention. Results: The patients in group 2 had a significantly greater symptomatic improvement based on subjective nasal obstruction scale SNOS scores than the patients in group 1 p<0.01 . Acoustic rhinometry ARM measurements without decongestant application showed significant increase in postoperative MCA2 Minimum Cross-sectional Area/cm2 2 and Vol 2 Volume/cm3 2 p<0.01 , while there was no significant change in MCA1 Minimum Cross-sectional Area/cm2 1 and Vol 1 Volume/cm3 1 . There was no statistically significant difference between the two groups with respect to ARM and anterior rhinoscopy AnR parameters p>0.05 . Conclusion: Based on these results, both radiofrequency ablation and microdebrider reduction may be considered as minimally invasive, straightforward, and reliable methods that provide sufficient airway passage without disruption of the nasal physiology.

Anahtar Kelimeler

Acoustic rhinometry, lower turbinate surgery, microdebrider, radiofrequency

Alt konka cerrahisinde radyofrekans ablasyon ile mikrodebrider redüksiyonunun burun fizyolojisi üzerine etkilerinin karşılaştırılması

Öz

Amaç: Bu çalışmada alt konka cerrahisinde radyofrekans ablasyon ve mikrodebrider redüksiyon yöntemlerinin nazal fizyoloji üzerine etkileri karşılaştırıldı.Hastalar ve Yöntemler: Ocak 2009 ve Mart 2010 tarihleri arasında alt konka hipertrofisi tanısı konulmuş ve burun tıkanıklığı yakınması olan 40 hasta randomize olarak radyofrekans grup 1, n=20 ya da mikrodebrider grup 2, n=20 ile tedavi edilmek üzere iki gruba ayrıldı. Burun tıkanıklığı, alt konka hipertrofisinin derecesi ve diğer semptomlar subjektif burun tıkanıklığı skalası ve anterior rinoskopi ile ameliyat öncesi ve cerrahi girişim sonrasındaki üçüncü gün, yedinci gün, dördüncü hafta ve sekizinci haftalarda incelendi.Bulgular: Subjektif nazal obstrüksiyon ölçeği SNOS skorlarına dayanarak grup 2’deki hastalarda grup 1’deki hastalardan daha fazla semptomatik iyileşme vardı p

Anahtar Kelimeler

Akustik rinometri, alt konka cerrahisi, mikrodebrider, radyofrekans

Kaynakça

• Tanyeri H, Boyaci Z. Reduction of the inferior turbinates with a microdebrider. [Article in Turkish] Kulak Burun Bogaz Ihtis Derg 2008;18:69-73.
• Candan H, Poyrazoğlu E, Kanımtürk E. İnferior konka hipertrofilerde submüköz türbinal rezeksiyon. GATA Bülteni 1990;32:823-8.
• Hilberg O. Objective measurement of nasal airway dimensions using acoustic rhinometry: methodological and clinical aspects. Allergy 2002;57:5-39.
• Cakmak O, Celik H, Ergin T, Sennaroglu L. Accuracy of acoustic rhinometry measurements. Laryngoscope 2001;111:587-94.
• 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.
• 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.
• Yanez C. New technique for turbinate reduction in chronic hypertrophic rhinitis: intraturbinate stroma removal using the microdobrider. Otolaryngology Head & Neck Surgery 1998;9:135-7.
• Lorenz KJ, Maier H. Microdebrider-assisted inferior turbinoplasty. Minimally invasive technique for the treatment of nasal airway obstruction caused by enlarged turbinates. HNO 2013;61:240-9. [Abstract]
• 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.
• Cingi C, Ure B, Cakli H, Ozudogru E. Microdebrider- assisted versus radiofrequency-assisted inferior turbinoplasty: a prospective study with objective and subjective outcome measures. Acta Otorhinolaryngol Ital 2010;30:138-43.
• Lee JY, Lee JD. Comparative study on the long-term effectiveness between coblation- and microdebrider- assisted partial turbinoplasty. Laryngoscope 2006;116:729-34.
• Vijay Kumar K, Kumar S, Garg S. A comparative study of radiofrequency assisted versus microdebrider assisted turbinoplasty in cases of inferior turbinate hypertrophy. Indian J Otolaryngol Head Neck Surg 2014;66:35-9.
• Chih-Wen T, Rong-San J, Shan-Hen W, Chen-Yi H. Acoustic Rhinometry in Measuring Nasal Volumes. Mid Taiwan J Med 2003;8:27-31.
• Bäck LJ, Hytönen ML, Malmberg HO, Ylikoski JS. Submucosal bipolar radiofrequency thermal ablation of inferior turbinates: a long-term follow-up with subjective and objective assessment. Laryngoscope 2002;112:1806-12.
• Kizilkaya Z, Ceylan K, Emir H, Yavanoglu A, Unlu I, Samim E, et al. Comparison of radiofrequency tissue volume reduction and submucosal resection with microdebrider in inferior turbinate hypertrophy. Otolaryngol Head Neck Surg 2008;138:176-81.
• Liu CM, Tan CD, Lee FP, Lin KN, Huang HM. Microdebrider-assisted versus radiofrequency-assisted inferior turbinoplasty. Laryngoscope 2009;119:414-8.