Radiofrequency Ablation Turbinoplasty versus Microdebrider-Assisted Turbinoplasty: A Systematic Review and Meta-analysis

• Published in: Otolaryngology-head and neck surgery Vol. 153; no. 6; p. 951
• Main Authors: Acevedo, Jason L, Camacho, Macario, Brietzke, Scott E
• Format: Journal Article
• Language: English
• Published: England 01.12.2015
• Subjects: Adult; Catheter Ablation; Debridement - instrumentation; Humans; Middle Aged; Nasal Obstruction - surgery; Treatment Outcome; Turbinates - surgery; Visual Analog Scale; allergic rhinitis; turbinate reduction; systematic review; turbinoplasty; nasal congestion
• ISSN: 1097-6817
• DOI: 10.1177/0194599815607211

To critically review published literature for treatment-related outcomes for bilateral inferior turbinate reduction (IFTR) via either microdebrider-assisted turbinoplasty (MAT) or radiofrequency turbinoplasty. The primary outcomes were relief of nasal obstruction according to visual analog scale and nasal airflow, volume, and resistance measures based on acoustic rhinomanometry. MEDLINE, EMBASE, The Cochrane Catalog, and CINAHL. The databases were searched with the terms "turbinoplasty" and "turbinate reduction." Inclusion criteria were English language, human subjects, and studies specifically relating to IFTR with radiofrequency turbinoplasty or MAT. Exclusion criteria were pediatric patients and concurrent nasal procedures. Results were tabulated, and the data were analyzed per random effects modeling. Subgroup analysis and quality assessment were also performed. A total of 976 articles were initially identified, with 26 meeting the inclusion/exclusion criteria. Random effects modeling demonstrated a significant improvement after IFTR, as measured with the visual analog scale (4.26-point improvement, 95% confidence interval [95% CI] = 3.32-5.20, P < .001, k = 21 studies, I(2) = 99%) and with acoustic rhinomanometry measurements of volume (2.43-cm(3) improvement, 95% CI = 0.48-4.38, P = .015, k = 6 studies, I(2) = 99%), flow (203-mL/s improvement, 95% CI = 131-276, P < .001, k = 4 studies, I(2) = 99%), and resistance change (2.78-Pa/cm(3) improvement, 95% CI = 0.433-5.13, P = .020, k = 5 studies, I(2) = 99%). There was no difference in outcome by technique, allergic rhinitis, or quality score. The 2 highest-quality papers favored MAT. The median follow-up was 6 months. IFTR produces a significant subjective and objective improvement in nasal airflow in the short term. This change does not appear to be related to the technique used for IFTR.