Radiofrequency for the treatment of allergic rhinitis refractory to medical therapy.
OBJECTIVE
The ideal treatment for allergic rhinitis refractory to medical therapy is still lacking. The aim of the study is to evaluate the efficacy of turbinate surgery with radiofrequency for the treatment of allergic rhinitis that is unresponsive to medical therapy.


METHODS
A prospective, nonrandomized clinical study.


METHODS
From February 2000 to April 2002, 108 consecutive patients (45 men and 63 women [mean age, 29.5 y]) with allergic rhinitis refractory to medical therapy who underwent radiofrequency turbinate surgery were enrolled in the study. Postoperative follow-up ranged from 12 to 26 months. A standard 0-to-10 visual analogue scale with an anchor was used to assess the pain and the allergic symptoms, including nasal obstruction, rhinorrhea, sneezing, itchy nose, and itchy eyes, preoperatively and postoperatively at the end of weeks 1 and 2 and months 1, 3, 6, and 12 after surgery. Statistical analysis was determined by repeated measures of ANOVA.


RESULTS
None of the 108 patients had obvious discomfort other than mild numbness over the premaxillary area (24 of 108 [22.2%]) during operation. Also, no adverse reactions including bleeding, infection, adhesion, or a worsening of allergic symptoms were encountered. One hundred one patients were included in the final statistical analysis. Only nine patients reported no improvement at all after treatment. The response rate of radiofrequency turbinate surgery for allergic rhinitis refractory to medical therapy was 91.1% (92 of 101). At 1 year after the treatment, the degree of nasal obstruction had changed on the visual analogue scale (mean +/- SD) from 6.84 +/- 2.09 to 2.47 +/- 1.60, an improvement of 63.9%. The degree of rhinorrhea had changed from 5.74 +/- 2.75 to 2.57 +/- 2.31, an improvement of 55.2%. The degree of sneezing had changed from 5.30 +/- 2.80 to 2.59 +/- 2.13, an improvement of 51.1%. The degree of itchy nose had changed from 3.74 +/- 3.16 to 1.82 +/- 2.27, an improvement of 51.3%. The degree of itchy eyes had changed from 3.17 +/- 3.09 to 1.68 +/- 2.38, an improvement of 47.0%. The visual analogue scale scores for nasal obstruction, rhinorrhea, sneezing, itchy nose, and itchy eyes decreased significantly with time, from preoperative scores to scores at 1 year after surgery. Other additional effects and improvements, including headache, lumpy throat, night cough, and tinnitus, were also reported by the patients. Most of the patients stated that they would consider repeating this procedure if necessary and would recommend the new method to their friends with the same problems.


CONCLUSIONS
The study demonstrates that radiofrequency appears to be an effective and safe tool for treating allergic rhinitis with poor response to medical therapy. In the future, radiofrequency has the potential to be one of the most popular surgical modalities for the treatment of allergic rhinitis refractory to medical therapy.
Lin
Hsin-Ching
HC
Department of Otolaryngology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, No. 123, Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien, 833, Taiwan.
Lin
Pei-Wen
PW
Su
Chih-Ying
CY
Chang
Hsueh-Wen
HW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D017115:Catheter Ablation; D002648:Child; D004351:Drug Resistance; D005260:Female; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000209:etiology; D012221:Rhinitis, Allergic, Perennial / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D013256:Steroids; D017211:Treatment Failure; D014420:Turbinates / Q000601:surgery*
D000893:Anti-Inflammatory Agents; D006634:Histamine H1 Antagonists; D006635:Histamine H2 Antagonists; D013256:Steroids