Comparison of the effects of radiofrequency tissue ablation, CO2 laser ablation, and partial turbinectomy applications on nasal mucociliary functions.
OBJECTIVE
One of the major causes of chronic nasal airway obstruction is disease of the inferior turbinate. However, there is no agreement on how to deal with this problem. Comparison was made of the nasal functions after treatment by radiofrequency tissue ablation, laser ablation, and partial turbinectomy using subjective symptom scores and objective tests.


METHODS
Prospective, randomized clinical trial.


METHODS
The study was conducted on three groups of 45 adult volunteer patients with symptoms and signs of nasal obstruction and stuffiness related to enlarged turbinates. In group A, laser ablation was applied to the inferior turbinate on one side and partial turbinectomy to the inferior turbinate on the other side. In group B, radiofrequency tissue ablation was applied to the inferior turbinate on one side and partial turbinectomy to the inferior turbinate on the other side. In group C, patients who were not treated by any surgical techniques were the control subjects. Clinical examinations, visual analogue scales, rhinomanometry, and isotopic study of nasal mucociliary transport time were used to assess treatment outcomes.


RESULTS
At 12 weeks after surgery, the nasal mucociliary transport time results were compared in the same patients. The average time was 25.60 minutes on the side where laser ablation was applied and 11.40 minutes on the side where partial turbinectomy (PT) was applied. In the patients on whom radiofrequency tissue ablation and partial turbinectomy were applied, the average nasal mucociliary transport time was 10.33 minutes on the radiofrequency tissue ablation side, whereas it was 11.33 minutes on the partial turbinectomy side. Rhinomanometric measurements demonstrated a significant decrease in nasal resistances at 12 weeks in both sides in groups A and B.


CONCLUSIONS
In the study it was demonstrated that radiofrequency tissue ablation to the turbinate is effective in improving nasal obstruction objectively and in preserving nasal mucociliary function. Laser ablation of the turbinate is effective in improving the nasal obstruction; however, it disturbs the mucociliary function significantly. With the partial turbinectomy technique, results obtained were similar to the results with the radiofrequency tissue ablation technique.
Sapçi
Tarik
T
Department of Otolaryngology-Head and Neck Surgery, Posta Telefon Telgraf Training Hospital, Gozenc sok. 14/9, 81070 Erenkoy-Istanbul, Turkey. tariksapci@turk.net
Sahin
Betül
B
Karavus
Ahmet
A
Akbulut
Uğur Günter
UG
D000328:Adult; D002245:Carbon Dioxide / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D009079:Mucociliary Clearance / Q000502:physiology*; D015508:Nasal Obstruction / Q000503:physiopathology* / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D011446:Prospective Studies; D025363:Rhinomanometry / Q000379:methods; D014420:Turbinates / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*
D002245:Carbon Dioxide