Radiofrequency Turbinate Reduction
Treatment of nasal obstruction
due to hypertrophic turbinates
The treatment of Swollen (hypertrophic)
inferior turbinates can be classified into conservative (non-surgical)
The conservative treatment includes medication
as well as avoidance of allergens and irritations ( eg dust mites,
pollen, dogs, cats) that caused the swelling.
Surgical treatment can be further divided
into invasive and non-invasive procedures.
Invasive surgeries would include partial
and total resection of the turbinates ( ie Inferior Turbinectomy)
and these entail General Anaesthesia and hospitalisation.
Non-invasive ( minially invasive) procedures
are more popular now as they can be done in the clinic under local
anaesthesia and the patient does not suffer any signficant down-time.
minimal invasive radio-frequency (RF) turbinate reduction
Sutter Medizintechnik GmbH of Freiburg Germany has successfully
produced a radio-frequency device with "Binner" bipolar
probes that is ideal for the treatment of the swollen turbinates.
Sutter has the AutoRF™ technology which has a function that constantly
controls and adjusts the power output of the radiofrequency unit
to prevent undesired tissue damage. If radiofrequency is applied
for too long, the system automatically adjusts and reduces the
output by up to 65 %.
This is especially important to the nasal mucosa as each of the
cells has a special feet-like cilia which functions like a conveyor
belt that moves mucus and other foreign particles for natural
Clinical research has shown that the Sutter RF turbinate reduction
gives result that is almost comparable with more invasive surgeries.
Below is an example of a recent publication:
Submucosal Radio Frequency of the Inferior Turbinates using
BM 780 II RF Generator and'Binner' Bipolar Electrode (Medical
by :Dr. R. Al-Hilou MB. ChB, D.L.O. (Lon) FRCS (Ed)
Ear, Nose & Throat Surgeon
Inferior Turbinate surgery including functional Procedure
and Invasion procedure. Recently the functional procedure involves
Radio Frequency energy for submucosal tissue ablation, which preserves
the service function of the inferior Turbinate mucosa.
Preliminary personal experience involving 45 patients. Procedures
performed over a period of six months (February to July 03)
using the Select-Sutter BM 780 II RF Generator (0.46 Mhz, power
70 watts in bipolar mode). All patients were sufferers of
nasal obstruction due to vasomotor rhinitis or allergic rhinitis
refractory to medical therapy.
We used 4% xylocain (occasional 10%) as local anaesthesia and
subsequent infiltration of 2% xylocaine without adrenaline.
We used the 15mm 'Binner' bipolar electrode with an exposed active
tip of 10mm in length. The BM 780 II was set at
level 2 (6 watts) in bipolar mode and radio frequency energy was
administered into the Turbinate for 9 to 10 seconds.
With the aid of a 0° endoscope, especially in the case
of severe hypertrophy of both inferior Turbinates, the Bipolar
inserted 3 or 5 times at various points along the Turbinate bone
including the hypertrophied tail of the Turbinate.
Ablation of the inferior Turbinate using radio frequency energy
was well tolerated by the majority of patients under local
anaesthesia. In only a few cases we reported slight, bearable
pain or pressure.
Inserting gauze tamponade for 3 to 5 minutes controlled the slight
exudation. No epistaxis was reported with exception to one
patient who reported epistaxis after 3 weeks. This was controlled
with silver nitrate cauterisation and an Entocel nasal packing
sponge, which was kept in place for two days. The patients were
advised to use normal saline as nasal irrigation for one
week after the procedure.All the patients attended two followed-up
visits during a period of 3 to 4 weeks for nasal cleaning of any
crust, which was minimal.
Nearly 90% of the patients reported
good improvement in nasal breathing, which was improving
further with time. Only 11% of
the patients (5 cases) reported unsatisfactory nasal patency in
one side and therefore required repeated ablation in one side
and the results of the second session were satisfactory in all
5 cases.There was no report of Turbinate necrosis or atrophy with
severe crust formation and we did not notice any post-operative
To date we have found the results satisfactory from both a subjective
and endoscopic point of view in nearly 90% of the cases treated.