Turbinates

Abstract: Objectives One of the major causes of chronic nasal airway obstruction is disease of the inferior turbinate. However, there is no agreement on how to deal with this problem. Comparison was made of the nasal functions after treatment by radiofrequency tissue ablation, laser ablation, and partial turbinectomy using subjective symptom scores and objective tests. Study Design Prospective, randomized clinical trial. Methods The study was conducted on three groups of 45 adult volunteer patients with symptoms and signs of nasal obstruction and stuffiness related to enlarged turbinates. In group A, laser ablation was applied to the inferior turbinate on one side and partial turbinectomy to the inferior turbinate on the other side. In group B, radiofrequency tissue ablation was applied to the inferior turbinate on one side and partial turbinectomy to the inferior turbinate on the other side. In group C, patients who were not treated by any surgical techniques were the control subjects. Clinical examinations, visual analogue scales, rhinomanometry, and isotopic study of nasal mucociliary transport time were used to assess treatment outcomes. Results At 12 weeks after surgery, the nasal mucociliary transport time results were compared in the same patients. The average time was 25.60 minutes on the side where laser ablation was applied and 11.40 minutes on the side where partial turbinectomy (PT) was applied. In the patients on whom radiofrequency tissue ablation and partial turbinectomy were applied, the average nasal mucociliary transport time was 10.33 minutes on the radiofrequency tissue ablation side, whereas it was 11.33 minutes on the partial turbinectomy side. Rhinomanometric measurements demonstrated a significant decrease in nasal resistances at 12 weeks in both sides in groups A and B. Conclusions In the study it was demonstrated that radiofrequency tissue ablation to the turbinate is effective in improving nasal obstruction objectively and in preserving nasal mucociliary function. Laser ablation of the turbinate is effective in improving the nasal obstruction; however, it disturbs the mucociliary function significantly. With the partial turbinectomy technique, results obtained were similar to the results with the radiofrequency tissue ablation technique.

Abstract: A method and apparatus for ablating at least a portion of a nasal concha. The apparatus includes a catheter having a distal portion with a dimension configured for positioning through a nostril of a patient into a nasal meatus adjacent a nasal concha, and an energy delivery device coupled to the catheter distal portion including one or more energy delivering probes extendable from the catheter distal portion a sufficient distance to be inserted into an interior of the nasal concha to deliver ablative energy therein. The distal portion of the apparatus may also include an expandable member, expansion of the expandable member within the nasal meatus immobilizing the distal portion within the nasal meatus.