Effects of radiofrequency ablation method due to inferior turbinate hypertrophy on the nasal mucociliary activity

Inferior turbinate hypertrophy is one of the most important reasons of nasal obstruction. There are several medical and surgical treatment procedures in the treatment of nasal obstruction due to inferior turbinate hypertrophy. The purpose in the concha surgery is to remove the nasal obstruction without damaging nasal physiology and resulting in complications.The aim of the study is to evaluate the effect of radiofrequency surgery on the nasal mucociliary activity before and after the radiofrequency ablation treatment in the inferior turbinate hypertrophy. The study was performed with 39 patients with inferior turbinate hypertrophy, 21 of them were male and 18 of them were female, who were referred to Otolaryngology Department of Medical School, Afyon Kocatepe University with complaint of nasal obstruction between June 18 and October 28, 2008. The patients whose nasal obstruction is due to only stromal inferior turbinate hypertrophy were included into the study.The effect of radiosurgery on the nasal mucociliary activity was determined by measuring the nasal mucociliary activity time with saccharin. A quarter tablet of saccharin was placed on the medial of the anterior end of inferior turbinate and the time till the saccharin was tasted for the first time was measured and recorded as saccharin transition time. Saccharin test was performed twice; before the radiofrequency treatment and 2 months after the treatment. Degree of nasal obstruction was evaluated with visual analog scale (VAS) twice; before and 2 months after the the treatment.The radiofrequency ablation was performed as follows: the ablation probe (GYRUS ENT Somnoplasty, Gyrus ENT, ENT LLC/dba Gyrus ENT, Barlett, USA), including specially designed tip with a diameter of 1.3 mm, suggested for the inferior turbinate was placed at the submucosa of the anterior, middle and posterior parts of the turbinate longitudinally after local anesthetic injection and energy of 350 joule was administered.VAS scores and nasal mucociliary activity time before and 2 months after the treatment was evaluated with paired t-test statistically. Value of p<0.05 was admitted as statistically significant.The mean age of 39 patients was 36.3±13.9 years (ranged from 16 to 67, median age of 37 years). Mean nasal mucociliary activity time before the treatment was measured as 9.82±4.41 minutes and 9.63±4.13 minutes 2 months after the treatment, and the difference between the two tests was not statistically significant (p=0.3). Mean VAS scores of nasal obstruction before the treatment was 6.48±1.19 and 3.83±0.97 two months after the treatment, and the difference between the two results was statistically significant (p=0.001). VAS scores and saccharin transition time values before and after the treatment between the genders were not significant (p>0.05).Our results demonstrated that the treatment of inferior turbinate hypertrophy, one of the most important reasons of nasal obstruction, with radiofrequency ablation did not have any effect on the mucociliary activity time, which has an important role in the nasal physiology. Furthermore, this treatment was shown to be fairly effective in the removal of nasal obstruction due to the inferior turbinate hypertrophy with the evaluation of VAS scores 2 months after the treatment. Radiofrequency ablation can be performed to one or more points of turbinates. Our results demonstrated that ablation to 3 points have supplied sufficient shrinkage at the turbinates.We believe that radiofrequency ablation performed to the inferior turbinate is a method which removes nasal obstruction efficiently without damaging nasal physiology and resulting in complications such as synechia, hyposmia, bad smelling, dryness, crust formation, hemorrhage that were reported in the other surgical techniques performed in the treatment of inferior turbinate hypertrophy in the literature up to now.