A randomized study of temperature-controlled versus bipolar radiofrequency for inferior turbinate reduction

Banhiran, Wish; Assanasen, Paraya; Tantilipikorn, Pongsakorn; Nujchanart, Nongyoa; Voraprayoon, Siriporn; Bunnag, Chaweewan

doi:10.1007/s00405-014-3410-y

Cited by 9 publications

(22 citation statements)

References 22 publications

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“…We identified 12 case series, 5 randomized clinical trials, and 1 prospective cohort study that met the inclusion criteria (Table 1). [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] In the present study, to identify the long-term outcomes of turbinate surgeries for AR, we compared preoperative and postoperative results in the same manner regardless of the study design. Thus, we ensured an appropriate number of patients in each group.…”

Section: Resultsmentioning

confidence: 99%

Long-term Outcomes of Turbinate Surgery in Patients With Allergic Rhinitis

Park

Kim

Jun

et al. 2023

JAMA Otolaryngol Head Neck Surg

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ImportanceTurbinate surgery is an effective treatment for allergic rhinitis (AR) refractory to medical treatment. However, the long-term outcomes of turbinate surgery are still unclear and have not yet been confirmed by a meta-analysis and systematic review of the literature.ObjectiveTo investigate the long-term outcomes and safety of turbinate surgery in AR by performing a meta-analysis.Data SourcesMEDLINE, Embase, the Cochrane Library, and ClinicalTrials.gov were searched through April 2021.Study SelectionStudies that analyzed turbinate surgery alone, had a follow-up period of more than 1 year, examined long-term efficacy of turbinate surgery, used current turbinate surgery methods, and were published in a peer-reviewed journal were included. Full-text reviews were performed by 2 independent reviewers. Conflicts were resolved by a third reviewer.Data Extraction and SynthesisDescriptive and quantitative data were extracted; weighted mean difference (WMD) was synthesized under a random-effects model. Heterogeneity was assessed using the Q statistic and the I2 metric. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines.Main Outcomes and MeasuresThe long-term outcomes of turbinate surgery on subjective nasal symptoms and objective parameters.ResultsOf the 3962 citations retrieved, 18 studies comprising 1411 patients were included. Findings showed significantly decreased symptom scores in nasal obstruction (WMD, 4.60, 95% CI, 3.43-5.76), rhinorrhea (WMD, 3.12; 95% CI, 1.97-4.28), sneezing (WMD, 2.64; 95% CI, 1.74-3.54), itching (WMD, 1.75; 95% CI, 1.20-2.30), and nasal resistance (WMD, 0.16; 95% CI, 0.08-0.24) and a significant increased total nasal volume (WMD, 0.96; 95% CI, 0.73-1.19). There was no significant difference in the occurrence of any complication. More than 1 year after surgery, the improvements in nasal obstruction (WMD, 5.18; 95% CI, 3.00-7.37), rhinorrhea (WMD, 3.57; 95% CI, 1.78-5.37), and sneezing (WMD, 2.95; 95% CI, 1.58-4.32) were maintained.Conclusions and RelevanceIn this systematic review and meta-analysis, turbinate surgery was associated with positive outcomes in AR and maintained the association during long-term follow-up. The rate of complications is also low. These findings can guide the preoperative counseling of patients with AR being considered for turbinate surgery.

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Section: Resultsmentioning

confidence: 99%

Long-term Outcomes of Turbinate Surgery in Patients With Allergic Rhinitis

Park

Kim

Jun

et al. 2023

JAMA Otolaryngol Head Neck Surg

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“…We did not find reports of major complications in literature. However, minor complications or rather nuisances such as mild to moderate crusting one week after an intervention have been reported 16 , whereas others did not observe such phenomena (Bran 7 ). We speculate that with regards to the thermal impact, frequency of the applied current plays an important role, as most bipolar RF treatment devices for the lower turbinates operate at frequencies between 350 kHz and 460 kHz.…”

Section: Discussionmentioning

confidence: 99%

“…For bipolar radiofrequency turbinate reduction, the reported results are mixed, too. Generally speaking, from a symptom-relief point of view, it must be considered as highly effective 7,[16][17][18][19] . We did not find reports of major complications in literature.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the thermal effects of Coblation and Radiofrequency waves in a porcine turbinate model

Vogt

Daine-Loza

Sperga

2018

Romanian Journal of Rhinology

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BACKGROUND. Radiofrequency reduction and Coblation are widely used procedures for the treatment of functionally enlarged turbinates with an appropriate outcome. Bleeding and crusting are postoperative complications for Coblation. Thermographic measurements and histological analyses were used to elucidate the causes. MATERIAL AND METHODS.In a porcine turbinate model, double-needle electrodes of different lengths were tested using a 4MHz radiofrequency current with either automatic energy limitation or a predetermined energy amount of 200 J. Coblation, according to the manufacturer's instructions, was carried out with a Reflex Ultra 45 wand. The generated temperature was measured with thermo-probes at the tip of the electrodes. The mucosa was subsequently investigated histologically. RESULTS. Without preoperative saline injection, all procedures generate temperatures < 100° C. After saline injection, excessive temperatures are reached by Coblation after the release of plasma in a closed system. The follow-up is a severe deterioration of the microscopic structures of the mucosa. The low-temperature advantages of Coblation are only effective if the mandatory saline solution rinses the surface. The Radiofrequency applications deliver more predictable results. CONCLUSION. For the treatment of the functional enlargement of the turbinates, Radiofrequency current with proofed settings should be chosen.

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“…Bony outfracture, the most atraumatic and conservative IT surgery, 2301 can reduce the distance between IT and lateral nasal wall and enlarge the dimensions of the nasal airway when performed alone 2302,2303 or in conjunction with other techniques 2304,2305 . IT surgery via energy‐related techniques 2304–2363 and via direct tissue removal 1093,2296,2299,2303,2307,2310,2331,2332,2335,2336,2338,2344,2364–2376 have both been extensively studied, with reported high efficacy in reducing symptoms and increasing nasal volume and airflow with minimal complications. Of note, botulinum toxin injection 2377–2379 and high‐intensity focused ultrasound may also provide symptomatic relief, 2380,2381 though there remains limited evidence for their utility.…”

Section: Managementmentioning

confidence: 99%

International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

Wise

Damask

Roland

et al. 2023

Int Forum Allergy Rhinol

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113

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Background In the 5 years that have passed since the publication of the 2018 International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (ICAR‐Allergic Rhinitis 2018), the literature has expanded substantially. The ICAR‐Allergic Rhinitis 2023 update presents 144 individual topics on allergic rhinitis (AR), expanded by over 40 topics from the 2018 document. Originally presented topics from 2018 have also been reviewed and updated. The executive summary highlights key evidence‐based findings and recommendation from the full document. Methods ICAR‐Allergic Rhinitis 2023 employed established evidence‐based review with recommendation (EBRR) methodology to individually evaluate each topic. Stepwise iterative peer review and consensus was performed for each topic. The final document was then collated and includes the results of this work. Results ICAR‐Allergic Rhinitis 2023 includes 10 major content areas and 144 individual topics related to AR. For a substantial proportion of topics included, an aggregate grade of evidence is presented, which is determined by collating the levels of evidence for each available study identified in the literature. For topics in which a diagnostic or therapeutic intervention is considered, a recommendation summary is presented, which considers the aggregate grade of evidence, benefit, harm, and cost. Conclusion The ICAR‐Allergic Rhinitis 2023 update provides a comprehensive evaluation of AR and the currently available evidence. It is this evidence that contributes to our current knowledge base and recommendations for patient evaluation and treatment.

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A randomized study of temperature-controlled versus bipolar radiofrequency for inferior turbinate reduction

Abstract: 1b.

Cited by 9 publications

References 22 publications

Long-term Outcomes of Turbinate Surgery in Patients With Allergic Rhinitis

Long-term Outcomes of Turbinate Surgery in Patients With Allergic Rhinitis

Comparison of the thermal effects of Coblation and Radiofrequency waves in a porcine turbinate model

International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

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