Radiofrequency Coblation versus Intramural Bipolar Cautery for the Treatment of Inferior Turbinate Hypertrophy

Abstract

Objectives: (1) Compare intramural bipolar electrocautery and radiofrequency coblation in the treatment of inferior turbinate hypertrophy with regard to objective and subjective improvement in nasal obstruction, rate and type of complications, experience during the procedure, and rate of recovery. (2) Describe 2 minimally invasive techniques in the management of turbinate hypertrophy with a comprehensive literature review of the efficacy of these methods. Methods: A prospective, randomized, single blinded study from 2008 to 2010 at a single tertiary medical center. Adult patients with inferior turbinate hypertrophy refractory to medical management were randomized to 2 groups based on which nostril they felt to be more obstructed. Patients were then treated with radiofrequency coblation in one nostril and intramural bipolar cautery in the other. Subjective and objective data, including use of a visual analog scale (VAS) for subjective outcomes, acoustic rhinometry, and nasal endoscopy, were then obtained from each patient comparing the 2 techniques. Results: Radiofrequency coblation was significantly less painful than intramural bipolar cautery for the early postoperative period ( P < .02), was considered less painful during the procedure ( P =.03), and produced less crusting at 3 weeks ( P = .009). Both interventions were similar in subjective and objective improvements in nasal obstruction as measured by acoustic rhinometry and subjective VAS outcomes. Conclusions: Radiofrequency coblation seems to offer an equivalent alternative to bipolar electrocautery for the treatment of inferior turbinate hypertrophy with less discomfort during the procedure and early postoperative period.

Industry Involvement in Otolaryngology: Updates from the 2017 Open Payments Database

“…Many of these devices have proven incredibly useful, decreasing surgical morbidity and potentially allowing surgical procedures to be performed in the office. [19][20][21][22][23] If persistent, this sign of decreased collaboration should be investigated further.…”

Introducing the new Coblation™ Turbinator™ turbinate reduction wand: Our initial experience of twenty‐two patients requiring surgery for nasal obstruction

“…There are many studies showing good clinical outcome with the use of Coblation™ for turbinate surgeries . The study with the longest follow‐up was conducted by the corresponding/senior author in 2006 which assessed the long‐term outcome (32 months) of CITR surgery using the Visual Analog Scale and posterior rhinomanometry .…”

“…They showed statistically significant improvement at three and 6 months of follow‐up. Shah et al compared clinical outcomes of coblation turbinoplasty and bipolar cauterization for reduction in inferior turbinates at 3 weeks and 6 weeks. There was statistically significant improvement in Visual Analog Scale (VAS) scores for both techniques; however, only the coblation technique showed statistically significant improvement in nasal volume and cross‐sectional area as measured using acoustic rhinomanometry.…”

“…This area is bound internally by the anterior end of the inferior turbinate and the adjacent nasal septum, thus an anterior deviation of the septum and inferior turbinate hypertrophy can contribute significantly to nasal obstruction. Inferior turbinate hypertrophy is initially managed medically . Patients who fail to benefit from medical management are referred for surgery which may include septoplasty and inferior turbinate reduction surgery.…”

“…Coblation™ (cold ablation) is a non‐thermal (40‐60°C) tissue reduction where radiofrequency energy is delivered through a conductive solution releasing charged plasma particles that break the molecular bonds . The effect is extensive fibrosis with reduction in submucosal glands and venous sinusoids but with intact basement membrane .…”