The patients evaluated in the current paper were originally treated in a randomized, placebo-controlled trial at the University of Oklahoma. A total of 32 patients were randomized to either active treatment or placebo. To be eligible for the trial, patients had to have prolonged nasal congestion and have been on medical treatment for allergic symptoms for at least six months.
Explore This IssueJune 2006
Eight weeks after treatment, patients came into the clinic and, using a visual analog scale (VAS), reported on the degree and frequency of symptom improvement. After filling out the follow-up questionnaire, patients in the placebo arm were told of their sham treatment and allowed to cross over. Twelve elected to do so.
Nineteen of the 28 patients who received treatment were available for a 24-month follow-up. The mean VAS score for the frequency of nasal obstruction was 7.8 at baseline, 4.8 at eight weeks post surgery, 4.6 at six months, and 4.1 at both one and two years. The mean VAS score for the severity of obstruction had a similar drop from 7.7 at baseline to 4.3, 4.9, 4.1, and 4.9 at each time-point, respectively. The mean VAS score for overall ability to breath declined from 7.5 prior to treatment to 4.0, 4.5, 4.0, and 4.2. All changes were statistically significant.
The team did not report any acute or long-term complications with this procedure, though Dr. Krempl noted that most patients have a very runny nose that lasts between two and five days. Furthermore, he did not find any reference to complications such as bleeding or crusting in published studies on RFVTR therapy for turbinate hypertrophy.
The technique, if it is done correctly, just damages undersurface, said Dr. Krempl. If you look at the side effects that occur from working on the turbinates, problems occur either from damaging the surface mucosa, including pain, crusting, and bleeding; from scar tissue on the surface; or from extreme temperature.
Comparing RFVTR to Submucosal Resection of the Turbinates
An Italian group led by Matteo Cavalier, MD, at the Moscati Hospital in Avellino, recently reported the results of a head-to-head comparison of RFVTR and traditional turbinoplasty using submucosal resection. Between January 2003 and December 2003, 75 patients were randomly assigned to one of three treatment arms, surgical resection, RFVTR, or no therapy. To be eligible all patients had to have nasal obstruction that was refractory to medical therapy for at least three months and signs of turbinate hypertrophy.