Three different turbinoplasty techniques combined with septoplasty: Prospective randomized trial

Laryngoscope. 2017 Feb;127(2):303-308. doi: 10.1002/lary.26264. Epub 2016 Sep 16.

Abstract

Objectives/hypothesis: Septal deviation and hypertrophic inferior turbinates are a frequent cause of nasal breathing disorders. The goal of this study was to prove the effectiveness and safety of three current turbinoplasty techniques.

Study design: This is a prospective, three-arm, single-blinded, single-center, randomized controlled trial.

Methods: Sixty patients were randomly assigned to either anterior turbinoplasty (ATP) (n = 20), radiofrequency ablation (RFA) (n = 19; Celon Pro Breath), or novel submucous radial diode laser ablation (DLA) (n = 21; ELVeS Radial PainLess, wavelength = 1,470 nm), each in combination with standard septoplasty. Acoustic rhinometry, rhinomanometry, subjective nose questionnaire, and saccharin test served as outcome parameters for preoperative and 3-month, 1-year, and 2-year postoperative examinations.

Results: After 3 months 47/60 patients were evaluated, 28/60 patients were evaluated after 1 year, and 26/60 patients were evaluated in the 2-year follow-up visit. An improvement of nasal breathing was observed in all three groups in all follow-up visits. The increase of endonasal volume 2 (volume between the nasal valve and body of the inferior turbinate) was statistically significant in the ATP and RFA group after 3 months and 2 years, and in the RFA group also after 1 year. The DLA group failed to reach significance level in all follow-up visits. Subjective evaluation of nasal breathing improved in all three groups.

Conclusions: In this trial, three different current techniques of turbinate surgery in combination with standard septoplasty were effective for the improvement of nasal breathing. The ATP and RFA techniques were more effective in the long term than DLA.

Level of evidence: 1b. Laryngoscope, 2016 127:303-308, 2017.

Keywords: 1470-nm laser; Turbinate surgery; acoustic rhinometry; anterior turbinoplasty; diode laser; nasal breathing disorder; radiofrequency ablation; septoplasty.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Catheter Ablation
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertrophy
  • Laser Therapy
  • Lasers, Semiconductor / therapeutic use
  • Male
  • Middle Aged
  • Nasal Obstruction / etiology
  • Nasal Obstruction / pathology
  • Nasal Obstruction / surgery*
  • Nasal Septum / abnormalities*
  • Nasal Septum / surgery*
  • Prospective Studies
  • Single-Blind Method
  • Turbinates / pathology
  • Turbinates / surgery*
  • Young Adult