Radiofrequency, high-frequency, and electrocautery treatments vs partial inferior turbinotomy: microscopic and macroscopic effects on nasal mucosa.

摘要

OBJECTIVE: To compare the microscopic and macroscopic effects of radiofrequency, high-frequency, and electrocautery therapies with partial inferior turbinotomy in the treatment of nasal obstruction caused by inferior turbinate hypertrophy. DESIGN: Nonrandomized controlled trial. SETTING: Department of Otolaryngology-Head and Neck Surgery, University of Genoa. PATIENTS: The study included 80 patients affected by nasal obstruction from hypertrophied inferior turbinates. INTERVENTIONS: Homogeneous patient groups A, B, C, and D underwent radiofrequency, high-frequency, and electrocautery treatments and partial inferior turbinotomy, respectively, to surgically reduce hypertrophied inferior turbinates. MAIN OUTCOMES MEASURES: Prior to surgery and at 7-day and 2-month follow-up evaluations, patients' outcomes were assessed via visual analogue scale, nasal endoscopy, nasal monofilament test, nasal mucociliary transport time (NMTT), anterior active rhinomanometry, and histologic examination of microbiopsy specimens from the inferior turbinate mucosa. RESULTS: Compared with groups A, B, and C 2 months after surgery, group D showed a lower subjective assessment of symptoms score, normal NMTT (vs an increase in all other groups), lower stimulus to trigger a touch response at monofilament test (vs hyposensitivity in the other groups), and absence of histologic changes. CONCLUSIONS: To our knowledge, no one has previously performed comparative studies to conclusively demonstrate which surgical technique is ideal. Our results show that the partial inferior nasal turbinotomy is the best method of treatment because it most effectively maintains satisfactory nasal physiologic integrity without damaging nasal mucosa or underlying nerves.