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Radiofrequency thermal ablation for patients with nasal symptoms: a systematic review of effectiveness and complications

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Radiofrequency ablation (RFA) is a relatively new method for the reduction of submucosal tissue. The method has gained increasing popularity in the treatment of snoring, tonsillar hypertrophy, tongue base hypertrophy, and nasal obstruction secondary to non-allergic or allergic rhinitis. We present a systematic literature review of current knowledge on the effectiveness, and complications of nasal radiofrequency thermal ablation (RFA) in the treatment of nasal obstruction. We performed a computerized literature search using several databases to select articles dealing with RFA treatment in the field of otorhinolaryngology. Selected articles were independently appraised by at least two of the authors. Thirty-five articles met the inclusion criteria. Twenty-six articles were reports on uncontrolled patient series. Of the nine included randomized controlled trials only one reported a double-blind comparison. Most of the studies reported an improvement in subjective symptoms after treatment and the number of serious side effects was small. However, the only placebo-controlled trial did not show effectiveness. Nasal-RFA appears to be a safe operative procedure and may reduce inferior turbinate submucosal tissue volume in patients having chronic nasal obstruction and who fail to respond to medical treatment. Based on current knowledge, RFA alters the nasal mucosa only slightly and causes only minor discomfort and risk of side effects for the patient. However, most of the published studies on nasal-RFA are observational and have a relatively short follow-up. Consequently, there is an urgent need for well-planned, double-blind, placebo-controlled randomized trials on nasal-RFA treatment.

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Acknowledgments

We are grateful to Ulla Neuvonen for performing the literature search and for help in literature retrieval. Dr. Johannes Guo helped in translating and interpreting the Chinese language articles and Dr. Marko Juutilainen with the Japanese-language article. The study was conducted under the sponsorship of the Finnish Office for Health Technology Assessment (http://finohta.stakes.fi/EN/index.htm).

Conflict of interest statement

AM and RPR have no clinical or commercial connections with RFA device producers. MH and LB use RFA devices in their clinical and research work. LB used in his studies RFA generators and applicators provided by the VidaMed Inc, USA (Bäck 2001) and Arthrocare Company, USA (Bäck 2002). MH was a co-author in the study of Bäck et al. (2002). LB and MH have no other connections with any of the device producers. Dr Hytönen has used a RFA device supplied by Arthrocare, USA, in one study [5]. Dr Bäck has used a RFA devices supplied by VidaMed (Bäck 2001) and Arthrocare, in two studies [5, 6].

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Central Hospital, P.O. Box 220, 00029 HUS, Helsinki, Finland

    Maija L. Hytönen & Leif J. J. Bäck

  2. Finnish Office for Health Technology Assessment, P.O. Box 220, 00531, Helsinki, Finland

    Antti V. Malmivaara

  3. Helsinki and Uusimaa Hospital District, P.O. Box 440, 00029 HUS, Helsinki, Finland

    Risto P. Roine

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  1. Maija L. Hytönen
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  2. Leif J. J. Bäck
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  3. Antti V. Malmivaara
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  4. Risto P. Roine
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Correspondence to Maija L. Hytönen.

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Hytönen, M.L., Bäck, L.J.J., Malmivaara, A.V. et al. Radiofrequency thermal ablation for patients with nasal symptoms: a systematic review of effectiveness and complications. Eur Arch Otorhinolaryngol 266, 1257–1266 (2009). https://doi.org/10.1007/s00405-009-0914-y

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  • DOI: https://doi.org/10.1007/s00405-009-0914-y

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