ORIGINAL RESEARCH—SINONASAL DISORDERS Comparison of radiofrequency tissue volume reduction and submucosal resection with microdebrider in inferior turbinate hypertrophy Zeynep Kizilkaya, MD, Kursat Ceylan, MD, Hatice Emir, MD, Ahmet Yavanoglu, MD, Ilhan Unlu, MD, Erdal Samim, MD, and Murat C. Akagün, MD, Ankara, Turkey OBJECTIVES: To compare the efficacy of submucosal tempera- ture-controlled radiofrequency tissue volume reduction (TCRFTVR) and resection with microdebrider (SMRM) in chronic inferior turbi- nate hypertrophy. STUDY DESIGN: Prospective, randomized, and single-blinded clinical trial. METHODS: The study group consisted of 30 symptomatic pa- tients who underwent simultaneous TCRFTVR and SMRM for consecutive sides. Visual analogue scale (VAS) and acoustic rhi- nometry (ARM) were made preoperatively and at 12th week and 6th month postoperatively; saccharine transport time (STT) and ciliary beat frequency (CBF) were performed at 12th week and 6th month postoperatively. The rate of the need for the revision oper- ation was determined between 6 and 12 months period postoperatively. RESULTS: Significant improvement was achieved in VAS scores and ARM measurements after both procedures, whereas both parameters did not differ significantly between two proce- dures postoperatively. STT and CBF showed no significant post- treatment variation in comparison of the intergroup measurements. The rates of the need for revision operation were not significantly different. CONCLUSION: Identical results in objective and subjective parameters were observed for both techniques. © 2008 American Academy of Otolaryngology–Head and Neck Surgery Foundation. All rights reserved. C hronic nasal obstruction is one of the most common human problems and a very frequent symptom in the ear, nose, and throat field. Hypertrophy of the inferior tur- binates is the most frequent cause and may be related to allergy, pseudoallergy, nonallergic rhinitis with eosinophilia syndrome, and iatrogenic rhinopathy. 1,2 Even though med- ical treatments are frequently effective to restore comfort- able nasal breathing, nasal obstruction is sometimes slightly improved, leading some patients to increase their consump- tion of local decongestants with a high risk of iatrogenic effects. In these cases, surgical reduction of inferior turbi- nates can be proposed. Various techniques are currently performed to reduce the volume of the mucosal (and some- times bony) tissues of the inferior turbinates. 3 Although most of these techniques provide satisfactory results for a more or less long period, adverse events are frequently observed after such treatments: postoperative bleeding, crusting, foul odor, pain, hyposmia, and synechia. 3,4 No technique is perfect, and each is associated with known short- and long-term complications. The variety of surgical techniques available indicates the lack of consensus on the optimal technique. 5 A new method for reducing the inferior turbinate with the use of a microdebrider to remove submucosal tissue was introduced in 1998. The common complications of standard submucous resection of inferior turbinates such as excessive resection, postoperative bleeding, and crusting were largely avoided and limited to postoperative bleeding in 1.6% of patients. This technique was also included in mucosal spar- ing techniques in turbinate reduction. 6-8 Recently, temperature-controlled radiofrequency tissue volume reduction (TCRFTVR) has been used for the treat- ment of the hypertrophied inferior turbinates. It uses heat generated from radiofrequency energy to create ionic agi- tation in the surrounding tissue, which induces submucosal necrosis. The circumscribed area of submucosal necrosis is replaced overtime by fibroblasts. Wound contraction by fibrosis results in submucosal tissue volume reduction and relief of nasal obstruction without causing damage to the overlying mucosa. Previous reports reflected that there is a recovery in patient-reported symptoms of obstruction with more than 90% improvement being achieved 8 weeks after treatment. 9-11 Mucociliary function is an important defense mechanism that protects the respiratory system against bacteria and other foreign particles. Nasal mucociliary function is im- paired in the majority of surgical reductions of the inferior Received January 3, 2007; revised October 30, 2007; accepted October 31, 2007. Otolaryngology–Head and Neck Surgery (2008) 138, 176-181 0194-5998/$34.00 © 2008 American Academy of Otolaryngology–Head and Neck Surgery Foundation. All rights reserved. doi:10.1016/j.otohns.2007.10.035