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PubMed1982

A reexamination of the effects of high rearing temperature on the nonolfactory turbinates of rats.

The nasoturbinates and maxilloturbinates have previously been reported to be completely resorbed in Wistar rats reared at 32-33 degrees C from 3 weeks to 6 months of age. The phenomenon was reinvestigated for the first time in the experiments reported here, with dramatically different results. Rats reared at 33 degrees C and 53% relative humidity proved to have naso- and maxilloturbinates of almost the same size as rats reared at 21 degrees C. After effects of skull and rostral size on turbinate size had been statistically removed, rearing temperature proved not to be important in explaining differences in turbinate widths or turbinate separation, but temperature and sex had significant interactive effects on turbinate lengths. Reasons why the turbinates were completely lost in the previous study but largely retained in the present study are unclear and probably subtle, given that procedures in the two studies were closely similar. Loss of the nonolfactory turbinates is demonstrably not a consistent response--adaptive or otherwise--to rearing under hot conditions, and probably factors in addition to temperature are critical to turbinate development.

Aging↗
PubMed2002

Comparison of laser induced effects on hyperplastic inferior nasal turbinates by means of scanning electron microscopy.

BACKGROUND AND OBJECTIVE: Various laser systems have been used for volume reduction of hyperplastic inferior nasal turbinates. Many studies have thus reported about clinical experiences concerning short and long term results. Although there are also some clinical investigations on histological changes after laser treatment, there is a lack of examinations by means of scanning electron microscopy (SEM) in order to especially investigate laser induced superficial tissue effects (ablation, carbonization, and coagulation). MATERIALS AND METHODS: Directly following operative excision, three hyperplastic nasal turbinates were treated by laser light of five common medical laser systems and their corresponding wavelengths, using identical laser parameters (irradiance, laser spot diameter) and a reproducible application procedure. After passing through an ethanol dehydration process, the thermal effects on the tissue (carbonization, coagulation, and ablation) were investigated and photographed via SEM. RESULTS: Depending on the laser wavelength used, tissue responses which could be observed by SEM greatly differ with respect to ablation, coagulation, and carbonization zones. While the CO(2) laser showed a precise cutting of tissue via ablation with only slight thermal effects on the adjoining tissue, Argon-ion-, Nd:YAG-, and diode-lasers provided for an intense destruction of both the surrounding, superficial respiratory epithelium, and the tissue in the depth of the turbinates, resulting from the development of rather large carbonization and coagulation zones. Ho:YAG-laser light induced precise vaporization in addition to remarkable superficial coagulation of the tissue, which was of smaller extent than after treatment with Nd:YAG- and diode-laser, but comparable to the Argon-ion-laser. CONCLUSIONS: In the course of this study SEM proved to be especially suitable for the examination of tissue changes on the surface of laser treated turbinates (i.g., destruction of respiratory epithelium). According to our results, Argon-ion-, Nd:YAG-, and diode-lasers seem to be useful for an effective and bloodless reduction of hyperplastic turbinates. However, broad coagulation zones may lead to consecutive complications and side effects. Due to its good ablation and superficial coagulation capabilities, Ho:YAG-laser light also seems to be usable for an effective turbinate reduction, but its low thermal effects in the depth of the tissue may lead to bleedings during treatment. Laser light of the CO(2) laser showed the lowest thermal tissue effects of the lasers investigated and therefore holds the risk of bleedings during treatment and the need of more than one therapeutic session to get a sufficient result. This investigation revealed that physicians, who are performing endonasal laser treatment, must be aware of the varying tissue effects of different medical laser systems to get a more aimed effect and to avoid intra- and post-operative complications (e.g., Rhinitis sicca, bone sequestration of the turbinate, bleedings, ...).

Adult↗
PubMed1998

Comparison of inflammatory cell profile and Th2 cytokine expression in the ethmoid sinuses, maxillary sinuses, and turbinates of atopic subjects with chronic sinusitis.

Chronic sinusitis is a common disease characterized by persistent inflammation of the sinus mucosa. This study was undertaken to investigate immunopathologic findings in biopsy specimens from the ethmoid sinuses, maxillary sinuses, and inferior nasal turbinates of 14 allergic subjects with chronic sinusitis. The composition of the inflammatory infiltrate in the three tissue sites was examined by immunocytochemistry with anti-CD3 (total T cells), anti-CD4 (helper T cells), anti-CD8 (suppressor T cells), anti-MBP (eosinophils), antitryptase (mast cells), and antichymase (mast cells) antibodies. These revealed a significant increase in the T-cell helper/suppressor ratio and eosinophils in the ethmoid sinus mucosa compared with those in the maxillary sinus mucosa and the inferior turbinate. Eosinophil numbers were also higher in the maxillary sinus than in the inferior turbinate. Mast cells were present in significantly higher numbers in the ethmoid sinus and inferior turbinate biopsy sections than in the maxillary sinus. With antisense, radiolabeled riboprobes, we used in situ hybridization to examine the expression of interleukin-4 and interleukin-5 transcripts. The density of cells expressing interleukin-4 transcripts was significantly higher in the inferior turbinate biopsy sections than in those from the ethmoid and maxillary sinuses. In addition, the number of interleukin-4 mRNA-positive cells was higher in the ethmoid than in the maxillary sinus mucosa. The density of interleukin-5 mRNA-positive cells was significantly higher in the ethmoid and maxillary sinuses than in the inferior turbinate. The results of this study indicate (1) a more intense inflammatory response in the ethmoid sinus than in the maxillary sinus and inferior turbinate in allergic chronic sinusitis and (2) different inflammatory responses in the upper airways that are dependent on the anatomic site. These findings have potential implications in the design of new therapeutic interventions for allergic chronic sinusitis.

Adolescent↗
PubMed2000

[In vitro experiments with Nd:YAG laser surgery on the turbinates].

BACKGROUND: Turbinate surgery is a therapeutic method for the treatment of the obstruction of nasal respiration. In this paper the dimensions of the laser lesions are described. In addition macro- and microscopical findings after laser surgery are given. METHODS: 10 human lower and 4 middle turbinates in vitro were treated with the Nd:YAG-laser in the non-contact mode (1064 nm, 2.5-25 W, cw). Stripe-like lesion with 3 cm length were produced. In addition the posterior end of the lower turbinates and the head of the middle turbinates were vaporized. RESULTS: Width, depth and volume of the lesions are given in dependence of laser power and irradiation time. The histological changes immediately after laser treatment are described. CONCLUSIONS: The energy doses for a clinical relevant stripe-like laser lesion of 3-4 cm in length of the lower turbinate is about 1500 Ws using Nd:YAG-laser. For evaporation of a posterior end of the lower turbinate 360 Ws are required using Nd:YAG-laser. For evaporation of the head of the middle turbinate a doses of about 1500 Ws are required using Nd:YAG-laser.

Feasibility Studies↗
PubMed2001

Long-term histologic effects of inferior turbinate laser surgery.

OBJECTIVE: In this study we sought to define the histologic changes produced by laser treatment of inferior turbinates. STUDY DESIGN: Eight inferior turbinates with prior laser treatment (mean, 26.8 months) were analyzed by light microscopy after turbinectomy for relief of refractory nasal obstruction. Histologic findings were compared with those of a group of 8 hypertrophic inferior turbinates that had no previous laser surgery. RESULTS: Laser-treated areas of the inferior turbinates demonstrated a histologically bland appearance, with marked diminution of seromucinous glands and relative preponderance of connective tissue matrix. Prominence of venous sinusoids was also significantly reduced in the laser-treated areas. Surface epithelium including goblet cells was reconstituted over the areas of laser application. CONCLUSION: Clinical laser surgery of the inferior turbinate produces striking long-term histologic changes. SIGNIFICANCE: The data suggest a differential response of turbinate histologic components to application of laser energy, with the glandular component being particularly sensitive. Further correlative study is needed to clarify the clinical significance of laser-induced histologic changes in inferior turbinates.

Adolescent↗
PubMed2001

Radiofrequency is a safe and effective treatment of turbinate hypertrophy.

OBJECTIVE: To evaluate the safety and efficacy of radiofrequency for reduction of inferior turbinate volume. STUDY DESIGN: Prospective before-and-after trial. METHODS: Fourteen patients complaining of chronic nasal obstruction and failing to respond to medical treatment were prospectively enrolled. All patients presented with inferior turbinate hypertrophy and no septal deformity. Radiofrequency inferior turbinate tissue reduction with three punctures in each turbinate (mean energy/puncture: 342 +/- 36 J, mean duration: 69 +/- 17 s, plateau tissue temperature: 75 +/- 6.4 degrees C). Patients were evaluated before and on days 3, 7, and 60 after intervention. RESULTS: No postoperative pain or complications were reported. Evaluation of nasal obstruction, quantified by visual analogue scale, showed a significant decrease of day time and nighttime obstruction after surgery. Acoustic rhinometry measurements showed that turbinate hypertrophy was significantly reduced in the sitting and supine positions on day 60 after surgery. Saccharin transit times decreased significantly on day 60 compared with preoperative measurements. Ciliary beat frequency, measured in vitro in nasal epithelial cells sampled from the inferior turbinate by brushing, was not significantly different before surgery and on day 60 after surgery. In the same samples, ciliated cells were the most abundant epithelial cell type before and after surgery, although in five cases, moderate numbers of squamous cells were detected on either day 7 or day 60 after surgery. CONCLUSION: Radiofrequency is a safe surgical procedure capable of reducing turbinate volume without altering the nasal mucosa, and causing minimal discomfort for the patient.

Catheter Ablation↗
PubMed2001

Long-term results of inferior turbinate reduction with argon plasma coagulation.

OBJECTIVES: Surgical reduction of the inferior turbinates is a commonly used therapy in patients with hyperplastic inferior turbinates when medical management remains ineffective. Current surgical methods have disadvantages (e.g., necessity of nasal packing, extended postoperative swelling, and high costs). Theoretical considerations render argon plasma coagulation (APC) a promising new therapeutic approach. STUDY DESIGN: In a prospective study, 121 patients with chronic nasal obstruction were treated for inferior turbinate reduction with APC. Hyperplasia of the nasal turbinates was diagnosed rhinoscopically and endoscopically and confirmed rhinomanometrically. The mean follow-up period was 12 months, ranging from 10 to 16 months. The treatment results were evaluated by a questionnaire, rhinomanometric findings, and electron microscopic studies of the nasal mucosa. In 50 patients a ciliary function test was performed preoperatively and postoperatively. METHODS: Argon plasma coagulation, a high-frequency electrosurgery, has been used for volume reduction of the inferior turbinate in local anesthesia. RESULTS: Seventy-six percent of the patients reported an improvement of the postoperative swelling within the first week. After 6 weeks, macroscopically the turbinates were re-epithelialized by normal mucosa in 63% of the patients. Electron microscopic studies after 3 months verified normal cilia. After 12 months, 83% of the patients stated that they had a better nasal airflow than preoperatively. Crust formation was minimal. No bleeding or impaired ciliary function occurred. Ninety-five percent of the patients were willing to undergo the same operation again. CONCLUSION: The long-term results have proved APC to be an effective and easy-to-perform alternative for inferior turbinate reduction with comparable results to other established surgical methods.

Adolescent↗
PubMed2002

The superior turbinate as a source of functional human olfactory receptor neurons.

OBJECTIVES: The function of human olfactory receptor neurons (ORNs) remains incompletely understood, in part because of the difficulty of obtaining viable olfactory tissue for study. During endoscopic sphenoidotomy, a portion of the superior turbinate is often removed to achieve wide and safe access to the sphenoid sinus. The purpose of this study was to determine whether functional olfactory mucosa could be obtained from such superior turbinate tissue. STUDY DESIGN/METHODS: Superior turbinate tissue was resected from 4 patients undergoing transnasal endoscopic approaches to the sphenoid sinus. The gross appearance of the turbinate mucosa was normal at the time of surgery. The specimens were placed directly into cold cell culture media and transferred to the laboratory. A portion of the mucosa was fixed and embedded for histology and immunohistochemistry. The remaining tissue was enzymatically dissociated, and the resulting cell suspension was either prepared for immediate calcium imaging or placed into cell culture. Cultured ORNs underwent calcium imaging after several weeks to assess their ability to respond to odorants. RESULTS: Histologic analysis of superior turbinate tissue revealed the presence of patchy olfactory neuroepithelium staining positive for olfactory marker protein. Acutely dissociated ORNs were capable of generating calcium responses to odorant mixtures. ORNs could be maintained in mixed culture and retained their ability to respond to odorants. CONCLUSIONS: Superior turbinate tissue removed during endoscopic sphenoidotomy can provide a valuable source of human olfactory neuroepithelium for functional or histologic study. Superior turbinate tissue yields stem cells and immature neurons capable of differentiating into ORNs that retain many of their functional characteristics even after growth in culture.

Cells, Cultured↗
PubMedDate not supplied

Middle turbinate resection: issues and controversies.

Diversity of opinion continues to exist among otolaryngologists regarding the potential benefits of preservation or resection of the middle turbinate during endoscopic ethmoidectomy. Rhinologists in favor of middle turbinate preservation cite the potential loss of olfactory function as well as diminished humidification and filtration of inspired air following its resection. In addition, the middle turbinate remnant could lateralize, causing frontal recess obstruction and frontal sinusitis. In general, it is accepted that a diseased or flail middle turbinate should be resected during ethmoidectomy to create a marsupialized surgical bed. However, in the case of a structurally sound middle turbinate, indications for resection vary significantly. We are reporting on 100 primary endoscopic ethmoidectomies for chronic rhinosinusitis followed for at least 2 years. Of these 100 sides, 50 included conservative partial middle turbinectomy and 50 were performed with middle turbinate preservation. The postoperative clinical and endoscopic findings revealed no difference in the incidence of frontal sinusitis or frontal recess stenosis between groups. We compared additional data and present our technique of conservative middle turbinate resection, which preserves a portion of this structure as an important anatomic landmark.

Adolescent↗
PubMed1984

Inferior turbinate surgery: an adjunct to successful treatment of nasal obstruction in 408 patients.

Septal deviation is often associated with hypertrophy of the contralateral inferior turbinate. Failure to reduce the size of the turbinate at the time of septal reconstruction may result in persistent nasal obstruction. The authors present their experience with 408 patients who underwent one of four turbinate procedures over a 6-year period. Most patients underwent unilateral turbinate surgery, although bilateral procedures were undertaken in 7 percent of patients. A graduated surgical approach was taken that varied according to the amount of turbinate enlargement and the degree to which mucosa and bone were involved. Full-thickness excision of the anterior third to half of the inferior turbinate (turbinectomy) became a favored procedure. Relief of nasal obstruction was obtained in greater than 90 percent of patients. Healing was satisfactory regardless of the method, and complications, including hemorrhage and infection, were few. Long-term follow-up revealed no untoward sequelae, and no patient developed atrophic rhinitis. The authors conclude that turbinate surgery, particularly when unilateral, in the carefully selected patient with nasal obstruction is a useful adjunct to septal surgery.

Humans↗
PubMed1977

Density of mucous glands in the normal adult nasal turbinates.

On 13 normal inferior and middle turbinates the mucous membrane was freed, stained by the PAS-alcian blue whole-mount method, and the mean density of glandular orifices was determined by counting in 4 mm2 fields. The median density fell in both turbinates in the anteroposterior direction, being in the inferior turbinate 8.2 glands/mm2 anteriorly, 7.9 in the middle, and 7.1 glands/mm2 posteriorly. In the middle turbinate it was 8.4 glands/mm2 anteriorly, 8.1 in the middle, and 7.3 glands/mm2 posteriorly. There were no significant differences in median density between the medial and lateral wall or between the superior and inferior half of the inferior or middle turbinate as a whole. The median total number of glands in the inferior turbinate was 9,200 with a very wide interindividual range of 6,100-12,700. In the middle turbinate the median count was 6,700 glands and the range 4,400-11,500. The pathology of the mucous glands of the nose is discussed.

Exocrine Glands↗
PubMed2001

A pilot study of measurement of the frequency of sounds emitted by high-speed dental air turbines.

Since the development and use of the high-speed dental air turbine some 45 years ago, concern has been expressed in the literature about a possible cause and effect relationship between use of the drill and hearing loss in dentists. The hearing threshold in humans varies with the frequency of sound. It is well known that dentists experience gradual hearing loss during their working life. The aim of this study was to measure the frequency of sounds emitted by high-speed dental air turbines under different working conditions. Five high-speed dental air turbines were used (2 x Trend TC-80 BC W&H Dentalwerk, Austria, 2 x Black Pearl Eco Bien-air, Switzerland, 1 x Trend TC-80 BC W&H Dentalwerk, Austria. Each turbine was tested under 8 different working conditions: under free working conditions the turbines were tested without burs, with fissure burs, with flare burs, with round burs and with inverted cone burs; under operation they were tested with fissure burs by application to a 3 x 3 x 10 mm amalgam block surface, a 3 x 3 x 10 mm composite block surface, and the occlusal surface of an extracted molar tooth. Forty sound recordings were made in total using a computer with a microphone (Shure 16 LC) located 30 cm away from the samples, at 10-s intervals using a mixer. Frequency analysis was done by a Cool Edit Pro 1.2 computer program. Data were analyzed by multi-variate analysis with the S.P.S.S 9.05 software program. The average measurement was 6860 Hz. According to the statistical analysis there was no significant difference in the frequencies recorded under different working conditions. There was also no significant difference among the different high-speed dental air turbines at alpha = 0,05, P > alpha /2 levels. These results indicate that under any working conditions, high-speed dental air turbines emit frequencies which can cause hearing loss.

Dental High-Speed Equipment↗
PubMed1996

Pneumatised superior turbinate: a common anatomic variation?

Anatomic variations are important in preendoscopic CT evaluation of the paranasal sinuses. In this study, we investigated whether the superior turbinate could become pneumatised like the middle turbinate, pneumatisation of which is well-known. Images of 52 patients who underwent CT examination prior to endoscopic sinus surgery and who had normally aerated posterior ethmoidal cells and an unobscured nasal cavity were retrospectively evaluated. The patients were 12-68 years old (median age, 35 years); 28 were women and 24 were men. Pneumatisation of the superior turbinates was graded in two groups as minimal or marked. Pneumatisation was evident in 25 patients (48%). 13 unilateral (25%), 8 bilateral (15%) pneumatisations were detected in the group graded as minimal, whereas 1 unilateral and 3 bilateral pneumatisations were present in the markedly (8%) pneumatised group of patients. Superior turbinates were seemingly aerated through the posterior ethmoid cells. The superior turbinates can be pneumatised as the middle turbinate is a not frequent anatomic variation that should be taken into account in preendoscopic CT evaluation of the paranasal sinuses.

Adolescent↗
PubMed2004

Classification of the inferior turbinate bones: a computed tomography study.

BACKGROUND: There are only few reports describing the texture of the inferior turbinate bone in normal and pathologic conditions. In this study, different types of human inferior turbinate bones were classified and radiological features of each type were defined. METHODS: The shape, structure and density of the inferior turbinate bones were evaluated using paranasal sinus computed tomography images of 283 patients. The cross-sectional areas of the bony part of the inferior turbinate were measured in bone windows. RESULTS: Human inferior turbinate bones were classified into four groups on the basis of different shape and structure as: Type I, lamellar; Type II, compact; Type III, combined type (compact with spongious component); Type IV, bullous. The distribution was as follows: 352 (62.19%) lamellar, 50 (8.83%) compact, 162 (28.63%) combined, and 2(0.35%) bullous type. CONCLUSION: Inferior turbinate bone is not in a uniform shape and structure. These diversities should be taken into consideration in radiological and clinical evaluation.

Adolescent↗
PubMed2005

Comparison of the effectiveness and safety of radiofrequency turbinoplasty and traditional surgical technique in treatment of inferior turbinate hypertrophy.

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.

Adult↗
PubMed1998

Radiofrequency volumetric tissue reduction for treatment of turbinate hypertrophy: a pilot study.

OBJECTIVES: Ideal treatment for nasal obstruction caused by turbinate hypertrophy remains in question. Medical therapy is often ineffective. Surgical procedures have associated morbidity including pain, bleeding, crusting, adhesion, infection, and dryness. Radiofrequency has recently been shown to be safe and effective in volumetric tissue reduction of the tongue in the animal model and of the palate in human beings. We prospectively evaluate the safety and effectiveness of radiofrequency volumetric tissue reduction (RFVTR) for the treatment of nasal obstruction caused by inferior turbinate hypertrophy. METHODS: Twenty-two consecutive patients with nasal obstruction and associated inferior turbinate hypertrophy refractory to medical therapy were evaluated for RFVTR. The study design limited the region of treatment to the anterior third of the inferior turbinate. The procedures were performed in an ambulatory facility with patients under local anesthesia. Clinical examinations, patient questionnaires, and visual analog scales were used to assess treatment outcomes. RESULTS: No adverse effects were encountered, including bleeding, crusting, dryness, infection, adhesion, or a worsening of obstruction. Mild edema was noted in all patients but was of short duration (24 to 48 hours). Posttreatment discomfort was well controlled with acetaminophen. Eight weeks after treatment, nasal breathing improved in 21 of 22 patients, with a 58.5% reduction in severity and a 56.5% decrease in the frequency of nasal obstruction. CONCLUSION: The results of this study demonstrate that RFVTR of the hypertrophic inferior turbinate is associated with minimal adverse effects. Furthermore, this new treatment modality achieves subjective improvement in patients with symptoms of nasal obstruction. However, because of the small sample size and short follow-up, future investigations are needed to fully evaluate the use of RFVTR in the treatment of nasal obstruction caused by turbinate hypertrophy.

Adolescent↗
PubMed2002

[First results of the wave-guide in CO2-laser surgical reduction of the hyperplastic nasal turbinates].

BACKGROUND: The CO2-laser-surgical reduction of the hyperplastic nasal turbinates represents a standard procedure in ENT-Surgery. In the presented paper, the authors introduce a new technique for the treatment of hyperplastic turbinates. METHODS: The laser beam is transmitted through a 90 degrees handpiece to the mobile "infra-guide" wave guide, which contains a 1 mm ceramic tube. By application of mirrow pieces with different angles, laser surgical reduction of those parts of the nasal turbinates is possible, which normally can not be reached by conventional, tangentially to the mucosa directed laser beams. The direction of the laser beam is controlled either optically, as in endonasal sinus surgery, or monitored through a camera. A total of 36 patients (22 women, 14 men, mean age 32.7 years) with nasal turbinate hyperplasia and either impaired nasal breathing and/or retronasal drip were treated with the new method. RESULTS: The laser wave guide represents a minimally invasive and basically complication-free method feasable on an outpatient basis. As a particular advantage, laser surgical reduction of the posterior parts of the inferior and also the middle turbinate is possible. The majority of the patients relates of an improvement of the preoperative symptoms (regarding reduction of impaired nasal breathing: 61.3 %, regarding reduction of post nasal drip 87.1 %). CONCLUSION: The laser wave-guide represents a basically complication-free, minimally invasive supplement to the different treatment modalities of the hyperplastic nasal turbinates.

Adult↗
PubMed1999

Radiofrequency energy tissue ablation for the treatment of nasal obstruction secondary to turbinate hypertrophy.

OBJECTIVE/HYPOTHESIS: We hypothesized that the success rate of radiofrequency energy (RFe) tissue ablation of the inferior turbinate for nasal obstruction achieved by previous investigators would be improved by using a longer needle electrode and creating two lesions per turbinate. METHODS: Ten patients with nasal obstruction secondary to inferior turbinate hypertrophy were prospectively enrolled. A 40-mm needle delivered RFe to two sites in each inferior turbinate. Patients used a visual analog scale (VAS) to grade nasal obstruction preoperatively and at 1 week and 8 weeks after surgery. Preoperative and postoperative digital images of the nasal cavity were graded for obstruction (0% to 100%) in a blinded manner. RESULTS: All patients (100%) were subjectively improved at 8 weeks. Mean obstruction (VAS) improved from 50%+/-21% to 16%+/-15% (right side) and from 53%+/-29% to 13%+/-13% (left side). Mean improvements were 68% (right side) (P = .004) and 75% (left side) (P = .001). Mean obstruction graded during blinded review of nasal cavity images improved from 73.5%+/-8% to 51%+/-8% (right side) and from 76%+/-6% to 64%+/-7% (left side). Of nine patients using medications for nasal obstruction before treatment, eight (89%) noted no further need for medications at 8 weeks. CONCLUSION: The use of RFe for submucosal tissue ablation in the hypertrophied inferior turbinate is an effective modality for reducing symptoms of nasal obstruction. Improved results may occur by using a longer needle and creating two lesions per turbinate. Of patients in this study, 100% reported improvement of nasal obstruction.

Aged↗