Abstract
The objective of this study is to compare outcomes of temperature-controlled radiofrequency (TCRF) and bipolar radiofrequency (BRF) for inferior turbinate reduction in patients with chronic rhinitis (CR). This was a prospective, randomized non-inferiority trial. Eighty-four adult patients with CR refractory to medication were randomized into two intervention groups: TCRF(42) or BRF(42). Primary outcomes consisted of patient-orientated visual analog scale (VAS; 0–10) of nasal obstruction at 4th postoperative week. Secondary subjective outcomes included VAS of nasal discharge, sneezing, hyposmia, and postnasal drip. Objective outcomes included crusting, mucociliary transportation time, minimal cross-sectional area, total nasal volume, and nasal airway resistance performed by blind assessors before and at 4th postoperative week and 1-year follow-up. Baseline and perioperative data showed no statistically significant difference between both groups, except for longer operative time in TCRF (481.5 ± 36.2 vs. 37.1 ± 3.0 s, p < 0.001) and slightly more crusts in BRF group (p = 0.04). Both intention-to-treat and per-protocol analyses, TCRF(39) versus BRF(41), revealed no significant difference among subjective and objective outcomes between two groups at 4th postoperative week. The 95 % confidence intervals of mean differences of VAS scores of all subjective symptoms were within defined margin (−1.5 to 1.5), except for nasal discharge. At 1-year follow-up, there was still no significant difference in the outcomes. Minimal pain and minor bleeding without serious adverse effects from both interventions were reported. Both BRF and TCRF resulted in similar short-term outcomes, while less operative time was found in BRF group. Further studies, particularly, on cost-effectiveness should be conducted for better treatment selection.
Level of evidence
1b.
Similar content being viewed by others
References
Assanasen P, Banhiran W, Kositchaiwat N, Bunnag C (2013) Prevalence of chronic rhinitis in Thai patients with obstructive sleep disordered breathing. J Med Assoc Thai 96:1169–1174
Lin HC, Lin PW, Su CY, Chang HW (2003) Radiofrequency for the treatment of allergic rhinitis refractory to medical therapy. Laryngoscope 113:673–678
Hytonen ML, Back LJ, Malmivaara AV, Roine RP (2009) Radiofrequency thermal ablation for patients with nasal symptoms: a systematic review of effectiveness and complications. Eur Arch Otorhinolaryngol 266:1257–1266
Garzaro M, Landolfo V, Pezzoli M et al (2012) Radiofrequency volume turbinate reduction versus partial turbinectomy: clinical and histological features. Am J Rhinol Allergy 26:321–325
Passali D, Lauriello M, Anselmi M, Bellussi L (1999) Treatment of hypertrophy of the inferior turbinate: long-term results in 382 patients randomly assigned to therapy. Ann Otol Rhinol Laryngol 108:569–575
Chen YL, Tan CT, Huang HM (2008) Long-term efficacy of microdebrider-assisted inferior turbinoplasty with lateralization for hypertrophic inferior turbinates in patients with perennial allergic rhinitis. Laryngoscope 118:1270–1274
Ishida H, Yoshida T, Hasegawa T, Mohri M, Amatsu M (2003) Submucous electrocautery following submucous resection of turbinate bone-a rationale of surgical treatment for allergic rhinitis. Auris Nasus Larynx 30:147–152
Kizilkaya Z, Ceylan K, Emir H et al (2008) Comparison of radiofrequency tissue volume reduction and submucosal resection with microdebrider in inferior turbinate hypertrophy. Otolaryngol Head Neck Surg 138:176–181
Sapci T, Sahin B, Karavus A, Akbulut UG (2003) Comparison of the effects of radiofrequency tissue ablation, CO2 laser ablation, and partial turbinectomy applications on nasal mucociliary functions. Laryngoscope 113:514–519
Coste A, Yona L, Blumen M et al (2001) Radiofrequency is a safe and effective treatment of turbinate hypertrophy. Laryngoscope 111:894–899
Cavaliere M, Mottola G, Iemma M (2005) Comparison of the effectiveness and safety of radiofrequency turbinoplasty and traditional surgical technique in treatment of inferior turbinate hypertrophy. Otolaryngol Head Neck Surg 133:972–978
Porter MW, Hales NW, Nease CJ, Krempl GA (2006) Long-term results of inferior turbinate hypertrophy with radiofrequency treatment: a new standard of care? Laryngoscope 116:554–557
Nease CJ, Krempl GA (2004) Radiofrequency treatment of turbinate hypertrophy: a randomized, blinded, placebo-controlled clinical trial. Otolaryngol Head Neck Surg 130:291–299
Assanasen P, Banhiran W, Tantilipikorn P, Pinkaew B (2014) Combined radiofrequency volumetric tissue reduction and lateral outfracture of hypertrophic inferior turbinate in the treatment of chronic rhinitis: short-term and long-term outcome. Int Forum Allergy Rhinol 4:339–344
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
Cavaliere M, Mottola G, Iemma M (2007) Monopolar and bipolar radiofrequency thermal ablation of inferior turbinates: 20-month follow-up. Otolaryngol Head Neck Surg 137:256–263
Li KK, Powell NB, Riley RW, Troell RJ, Guilleminault C (1998) Radio frequency volumetric tissue reduction for treatment of turbinate hypertrophy: a pilot study. Otolaryngol Head Neck Surg 119:569–573
Harrill WC, Pillsbury HC 3rd, McGuirt WF, Stewart MG (2007) Radio frequency turbinate reduction: a NOSE evaluation. Laryngoscope 117:1912–1919
Banhiran W, Tantilipikorn P, Metheetrairut C, Assanasen P, Bunnag C (2010) Quality of life in patients with chronic rhinitis after radiofrequency inferior turbinate reduction. J Med Assoc Thai 93:950–960
Garzaro M, Pezzoli M, Landolfo V, Defilippi S, Giordano C, Pecorari G (2012) Radio frequency inferior turbinate reduction: long-term olfactory and functional outcomes. Otolaryngol Head Neck Surg 146:146–150
Li HY, Wang PC, Chen YP, Lee LA, Fang TJ, Lin HC (2011) Critical appraisal and meta-analysis of nasal surgery for obstructive sleep apnea. Am J Rhinol Allergy 25:45–49
Carroll W, Wilhoit CS, Intaphan J, Nguyen SA, Gillespie MB (2012) Snoring management with nasal surgery and upper airway radiofrequency ablation. Otolaryngol Head Neck Surg 146:1023–1027
Powell NB, Zonato AI, Weaver EM et al (2001) Radiofrequency treatment of turbinate hypertrophy in subjects using continuous positive airway pressure: a randomized, double-blind, placebo-controlled clinical pilot trial. Laryngoscope 111:1783–1790
Blumen MB, Chalumeau F, Gauthier A, Bobin S, Coste A, Chabolle F (2008) Comparative study of four radiofrequency generators for the treatment of snoring. Otolaryngol Head Neck Surg 138:294–299
Acknowledgments
The authors would like to thank Ms. Jeerapa Kerdnoppakurn (research assistant) for her data input, Mr. Suthipol Udompunturak (statistician) for the randomization and data analysis, staffs in the Department of Oto-Rhino-Laryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, and all patients who had contributed to this study. Registration number: ClinicalTrals.gov NCT01054521. This study was funded by the Faculty of Medicine Siriraj Hospital, Mahidol University.
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Banhiran, W., Assanasen, P., Tantilipikorn, P. et al. A randomized study of temperature-controlled versus bipolar radiofrequency for inferior turbinate reduction. Eur Arch Otorhinolaryngol 272, 2877–2884 (2015). https://doi.org/10.1007/s00405-014-3410-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-014-3410-y