Comparison of the effects of radiofrequency tissue ablation, CO2 laser ablation, and partial turbinectomy applications on nasal mucociliary functions.

OBJECTIVES: 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. STUDY DESIGN: 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.

[Results of open structure rhinoplasty]. / Açik teknik rinoplasti sonuçlarimiz.

OBJECTIVES: This study aimed to evaluate the techniques used in open structure rhinoplasty operations, together with a presentation of our results and experience. PATIENTS AND METHODS: The study included 122 patients (64 males, 58 females; mean age 27 years; range 17 to 48 years) who underwent open structure rhinoplasty. Of these, 72.9% had primary, 9% had revision surgeries; 18% had traumatic deformities. The mean follow-up period was 18 months (range 3 to 24 months). RESULTS: We did not encounter transcolumellar scar formation or flap necrosis in any of the cases. In five cases (4%), edema and hyperemia were detected in the columellar skin in the early postoperative period. Resorption of the tip graft developed in one (0.8%) of the patients in whom auricular cartilage grafts were used. A year after surgery, one patient (0.8%) presented with granulation tissue formation in the nasal vestibule, secondary to the use of nylon suture material. Axial deviation was seen in the early postoperative period in two patients (1.6%). Five patients (4%) required revision surgery. CONCLUSION: Open structure rhinoplasty gives excellent results when employed on proper indications and by experienced surgeons.

[Results of radiofrequency tissue ablation]. / Radyofrekans cerrahisi sonuçlarimiz.

OBJECTIVES: We evaluated the effectiveness of radiofrequency tissue ablation in respiratory obstruction due to snoring and turbinate hypertrophy. PATIENTS AND METHODS: Thirty-three patients (9 females, 24 males; mean age 35.3 years; range 19 to 55 years) underwent 38 submucosal probe applications in the inferior turbinate (n = 15), soft palate (n = 13), and both (n = 5). Applications were performed in four regions of the soft palate, and in the anterior, medial, or posterior regions of the inferior turbinate depending on the hypertrophic site. Evaluations were made prior to, in the second month, and at the end of the first year of treatment. Snoring was evaluated using the Epworth Sleepiness Scale and subjective assessment. Respiration was evaluated by a visual analog scale. Maximum follow-up period was one year. RESULTS: Subjective evaluations made at the end of the first year showed that snoring decreased in 44.5% and disappeared in 50%. No change was observed in 5.5%. According to the patients' subjective evaluations and clinical examination findings complaints of obstruction decreased by 65.4% and 45.61%, respectively. No significant complications occurred. CONCLUSION: Radiofrequency tissue ablation may prove to be useful in appropriate patients. It is minimally invasive, requires low power and heat, and no general anesthesia, and is associated with low complication risks.