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January 2011—Michael Friedman, MD
Dr. Friedman added that more aggressive techniques are not right for every patient. “Sometimes patients are very responsive to medical therapy, and it would be appropriate. However, many patients are reluctant to be on long-term steroids. Although it used to be accepted as having a good safety profile, there is more awareness now of the potential side effects of steroids and other medications.”
While some patients are reluctant to stay on medications for an extended period of time, others don’t respond to steroids or topical medications and don’t want to take systemic medications their whole lives, Dr. Friedman added. “Once we decide to treat the turbinate, the right procedure is determined by the needs of the patient,” he said. “It is not one procedure that is the best procedure. For example, if the patient has a bony turbinate, then RF turbinoplasty would not be the right procedure. A submucousal resection would be a more aggressive procedure giving better results.”
As for other limitations of RF turbinoplasty, Dr. Lin said poor outcomes are possible for patients who have had invasive or nasal turbinate surgeries, a history of radiotherapy for their head and neck cancers, chronic rhinosinusitis with polyposis or the disease of rhinitis medicamentosa caused by extended use of topical decongestants.