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

• Published in: European archives of oto-rhino-laryngology Vol. 272; no. 10; pp. 2877 - 2884
• Main Authors: Banhiran, Wish, Assanasen, Paraya, Tantilipikorn, Pongsakorn, Nujchanart, Nongyoa, Voraprayoon, Siriporn, Bunnag, Chaweewan
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2015
• Subjects: Adult; Aged; Aged, 80 and over; Catheter Ablation - methods; Female; Head and Neck Surgery; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Mucociliary Clearance; Nasal Mucosa - surgery; Nasal Obstruction - surgery; Neurosurgery; Otorhinolaryngology; Postoperative Period; Prospective Studies; Rhinology; Temperature; Turbinates - surgery; Young Adult; Temperature controlled; Bipolar; Inferior turbinate reduction; Thai; Radiofrequency; Chronic rhinitis
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-014-3410-y

The objective of this study is to compare outcomes of temperature-controlled radiofrequency (TCRF) and bipolar radiofrequency (BRF) for inferior turbinate reduction in patients with chronic rhinitis (CR). This was a prospective, randomized non-inferiority trial. Eighty-four adult patients with CR refractory to medication were randomized into two intervention groups: TCRF(42) or BRF(42). Primary outcomes consisted of patient-orientated visual analog scale (VAS; 0–10) of nasal obstruction at 4th postoperative week. Secondary subjective outcomes included VAS of nasal discharge, sneezing, hyposmia, and postnasal drip. Objective outcomes included crusting, mucociliary transportation time, minimal cross-sectional area, total nasal volume, and nasal airway resistance performed by blind assessors before and at 4th postoperative week and 1-year follow-up. Baseline and perioperative data showed no statistically significant difference between both groups, except for longer operative time in TCRF (481.5 ± 36.2 vs. 37.1 ± 3.0 s, p  < 0.001) and slightly more crusts in BRF group ( p  = 0.04). Both intention-to-treat and per-protocol analyses, TCRF(39) versus BRF(41), revealed no significant difference among subjective and objective outcomes between two groups at 4th postoperative week. The 95 % confidence intervals of mean differences of VAS scores of all subjective symptoms were within defined margin (−1.5 to 1.5), except for nasal discharge. At 1-year follow-up, there was still no significant difference in the outcomes. Minimal pain and minor bleeding without serious adverse effects from both interventions were reported. Both BRF and TCRF resulted in similar short-term outcomes, while less operative time was found in BRF group. Further studies, particularly, on cost-effectiveness should be conducted for better treatment selection. Level of evidence 1b.