Comparison of the efficacy and adverse effects of bipolar radiofrequency turbinate reduction with and without lateral outfracture in the treatment of inferior turbinate hypertrophy: A randomized controlled trial

Abstract

Background : Radiofrequency inferior turbinate reduction has been proven to reduce the volume of the inferior turbinate. The aim of lateral outfracture of the inferior turbinate is to displace the position of the inferior turbinate laterally which makes the nasal cavity wider. The efficacy of the lateral outfracture is questionable. However, some authors usually combine lateral outfracture of the inferior turbinate with other techniques of inferior turbinate reduction.

Objective : To compare efficacy and adverse effects between bipolar radiofrequency turbinate reduction with lateral outfracture (BRTR with LO) and bipolar radiofrequency turbinate reduction alone (BRTR alone) in chronic rhinitis patients with inferior turbinate hypertrophy.

Setting : Department of Otolaryngology, King Chulalongkorn Memorial Hospital

Research design : Randomized controlled trial

Material and Methods : Fifty patients were enrolled. Intervention was randomized and performed by BRTR with LO or BRTR alone. Nasal obstruction symptom on postoperative week 8, total nasal volume on postoperative week 8 and adverse effects were compared. The outcome assessor, who was not the surgeon, and the patients were blinded to the treatment allocation.

Results : Means ± SD of the preoperative and postoperative week 8 nasal obstruction symptom scores in BRTR with LO group were 7.13 ± 1.26 and 1.60 ± 1.40, respectively. In BRTR alone group, there were 7.03 ± 1.55 and 1.11 ± 1.36, respectively. Medians (IQR) of the nasal obstruction symptom on week 8 in BRTR with LO and BRTR alone groups were 1.40 (0.35 - 2.55) and 0.70 (0.05 - 1.70), respectively. The difference did not have statistical significance (p = 0.100). Means ± SD of the nasal volume on postoperative week 8 in BRTR with LO and BRTR alone groups were 9.97 ± 1.84 and 10.11 ± 2.24, respectively. The difference did not have statistical significance (p = 0.822), Medians (IQR) of the intraoperative pain in BRTR with LO and BRTR alone groups were 2.30 (0.50 - 4.90) and 0.90 (0.15-6.25), respectively. The difference did not have statistical significance (p = 0.600), Medians (IQR) of the postoperative pain day 1 in BRTR with LO and BRTR alone groups were 0.60 (0.30 - 2.95) and 0.50 (0.15 - 2.95), respectively. The difference did not have statistical significance (p = 0.669), Proportions (%) of none/mild/ moderate/severe postoperative bleeding in BRTR with LO and BRTR alone groups were = 4/64/28/4 and 20/64/16/0, respectively. The difference did not have statistical significance (p = 0.214).

Conclusion : No statistically significant differences of the efficacy and adverse effects were found between bipolar radiofrequency turbinate reduction with lateral outfracture and bipolar radiofrequency turbinate reduction alone in chronic rhinitis patients with inferior turbinate hypertrophy. Although no statistical significance in adverse effects, severe postoperative bleeding was observed in one patient who underwent bipolar radiofrequency turbinate reduction with lateral outfracture.