Artikel
Bipolar radiofrequency surgery versus placebo in the treatment of inferior turbinate hypertrophy
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Autoren
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Boris A. Stuck
- Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim, Germany
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Sophie Hünnebeck
- Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim, Germany
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Karl Hörmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim, Germany
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Gergor Bran
- Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim, Germany
| Veröffentlicht: | 3. August 2011 |
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Gliederung
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Introduction: Various treatments of nasal obstruction due to inferior turbinate hypertrophy are currently available and the ideal treatment has still to be determined. Prospective trials on a high level of evidence are only available in selected cases, although controlled trials are of particular importance with regard to the high variability of symptoms and objective measures of nasal obstruction.
Methods: 20 patients with isolated hypertrophy of the inferior turbinate and resulting nasal obstruction were included in this prospective, single-blinded cross-over trial. The course of the two interventions (radiofrequency or placebo) was randomized, one group received radiofrequency surgery first followed by placebo and vice versa. Radiofrequency surgery consisted in 2–3 lesions at the inferior turbinate on both sides under local anesthesia, while placebo consisted in a comparable approach (needle-insertion under local) without energy application. Before and six weeks after treatment anterior rhinomanometry was performed and the patients rated the degree of nasal obstruction (0: no to 4: major obstruction) and the overall satisfaction with the procedure (0: low to 4: high). In addition, complications were assessed during and after surgery. Thereafter, the treatment was repeated with the alternative intervention (cross-over).
Results: Nasal airflow increased following radiofrequency surgery by 128.8 ml/s and deteriorated after placebo by 71.6 ml/s (average). Nasal obstruction score was improved by 1.69 points after radiofrequency surgery while it was only reduced by 0.31 points after placebo. The differences between the two groups were statistically significant for both measures. Overall satisfaction with the procedure was higher after radiofrequency surgery (3.16 points) compared to placebo (0.5). Complications were not recorded.
Conclusion: Bipolar radiofrequency surgery of the inferior turbinates is superior to placebo in the treatment of nasal obstruction. This study documents the effectiveness of bipolar radiofrequency surgery of the inferior turbinates at a high level of evidence.
