Radiofrequency volumetric tissue reduction of the inferior turbinate in a sheep model

Kakarala, Kiran; Faquin, William C.; Cunningham, Michael J.

doi:10.1002/lary.23201

Cited by 8 publications

(3 citation statements)

References 22 publications

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“…In a rabbit model, Kaplama et al [29] used 25 W at 30 seconds. In a sheep model, Kakarala et al [23] applied 20 W at 10 seconds to the turbinates. Gouveris et al [24] only states that a “constant power” was applied for 15 seconds in a sheep model.…”

Section: Discussionmentioning

confidence: 99%

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Electrosurgery Turbinate Reduction Revisited: Can Comparable Volumetric Heating be Achieved Without Feedback Control?

et al. 2020

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Background and Objectives: Temperature-controlled radiofrequency inferior turbinate ablation (TCRFA) uses a feedback system to control thermal injury and achieve precise volumetric heating to induce specific scar formation. However, it requires costly single-use proprietary consumables. Comparable volumetric tissue heating may be achieved for a fraction of the cost by adjusting the power settings on traditional monopolar electrosurgery devices that use low-cost needle tips. This pre-clinical study aims to determine the optimized power parameters to achieve electrosurgical coagulum volume similar to that of TCRFA. Study Design/Materials and Methods: An electrosurgery submucosal diathermy (SMD) system (cut mode, 4-32 W, 5-120 seconds) and a temperature-controlled radiofrequency ablation system (standard clinical parameters for treating inferior turbinate hypertrophy) were used to coagulate egg white and chicken breast. Coagulum major and minor axis were measured, and lesion volume was approximated as prolate spheroid. Results: No significant difference in volume was found between the temperature-controlled system and the electrosurgery system at 8 W for 30 seconds, 8 W for 60 seconds, 16 W for 30 seconds, 32 W for 5 seconds, and 32 W for 15 seconds. The time to achieve equivalent lesion size was significantly less in the SMD system when compared to the temperature-controlled system (P < 0.05). Conclusion: Electrosurgery handpieces may achieve similar lesion volume effects as the temperature feedbackcontrolled, single-use handpieces when set to the optimized parameters. SMD handpieces are significantly more cost and time effective than proprietary devices, and they are easily used in the office. SMD devices may be a more affordable alternative to temperature-controlled systems with comparable lesion volume effect and may be valuable for office-based therapy. Lasers Surg. Med.

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Section: Discussionmentioning

confidence: 99%

“…Therefore, 480, 120, 240, 480, 240, 480, 160, and 480 J were applied, respectively. These settings encompass the power and times used in previous SMD studies, but they do not exactly replicate them [23,24]. After each trial, the coagulated egg white was gently removed from the reservoir and the procedure was repeated.…”

Section: Egg White Phantommentioning

confidence: 99%

Electrosurgery Turbinate Reduction Revisited: Can Comparable Volumetric Heating be Achieved Without Feedback Control?

et al. 2020

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“…As oestrogens have an effect of nasal swelling and the menstrual cycle may influence wound healing parameters there was concern that this fact may confound wound healing studies' findings in female sheep. Nonetheless, other studies of wound healing in the nasal and paranasal cavities have also used the female sheep as an animal model and there is previous experience in using female sheep for studying inferior nasal turbinate wound healing successfully (8) . In view of the aforementioned potentially confounding oestrogen effect, monitoring of the hormonal state in female sheep in future studies is recommended.…”

Section: Discussionmentioning

confidence: 99%

Immunohistochemical studies of wound healing after monopolar electrocautery and ultrasound submucosal inferior nasal turbinate reduction in sheep

Nousia

Gouveris²,

Giatromanolaki³

et al. 2013

Rhin

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Background: Extracellular matrix (ECM) proteins such as fibronectin and collagen III, enzymes such as matrix metalloproteinases and macrophages have been demonstrated to intervene in nasal and paranasal sinuses wound healing. Aim of the study: To compare concentration of ECM proteins, enzymes and the recruitment of macrophages during wound repair after monopolar electrocautery in contrast with ultrasound submucosal surgical tissue reduction of inferior nasal turbinate (INT) tested in sheep. Materials and methods: Prospective controlled study in sheep. Immunostaining for collagen III, fibronectin, CD68 and matrix metalloproteinase-9 (MMP9) was applied in tissue specimens of INT mucosa after monopolar electrocoagulation (MEC) and ultrasound tissue reduction (UTR). Twelve INTs were studied 1, 3 and 8 weeks post-operatively in each interventional group (MEC and UTR) and 5 INTs were studied in animals of the control group (without surgery). The immunoreactivity was quantitatively graded between 0% to 100% immunoreactivity by a blinded senior pathologist. Results: At the end of the study period collagen III, fibronectin and MMP9 were increased in both groups compared to the levels of the control group. When compared to control group, CD68 immunoreactivity was found higher in MEC group but not in UTR group. Fibronectin subepithelial immunoreactivity exhibited a substantial negative correlation with mucosal epithelial cell necrosis, a substantial positive correlation with fibrosis in MEC-treated specimens and a significant positive correlation with sinusoid engorgement in UTR-treated specimens. Collagen III tissue immunoreactivity showed a particularly significant negative correlation with sinusoid engorgement in MEC-treated specimens. Conclusion: Correlation of fibronectin and collagen III immunoreactivity to histopathologic findings suggests different ECM repair processes between MEC and UTR turbinate tissue reduction. The use of CD68 and MMP9 provides additional clues to the mode of actions of these techniques and to the molecular and cellular events of the nasal mucosa wound healing process.

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Clinical and histologic studies of olfactory outcomes after nasoseptal flap harvesting

et al. 2013

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Radiofrequency volumetric tissue reduction of the inferior turbinate in a sheep model

Cited by 8 publications

References 22 publications

Electrosurgery Turbinate Reduction Revisited: Can Comparable Volumetric Heating be Achieved Without Feedback Control?

Electrosurgery Turbinate Reduction Revisited: Can Comparable Volumetric Heating be Achieved Without Feedback Control?

Immunohistochemical studies of wound healing after monopolar electrocautery and ultrasound submucosal inferior nasal turbinate reduction in sheep

Clinical and histologic studies of olfactory outcomes after nasoseptal flap harvesting

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