Radiofrequency Ablation for Inferior Turbinate Hypertrophy: Predictive Factors for Short and Long-Term Outcomes

Abstract

Objectives: Radiofrequency Ablation (RFA) is a widely used technique for treatment of nasal obstruction due to inferior turbinate hypertrophy. This study aims to evaluate short and long-term outcome after RFA. Secondly, predictive factors for this outcome were evaluated. Methods: A prospective clinical study was performed in 65 patients to evaluate short-term outcome and predictive factors (Study A). To evaluate long-term outcome and predictive factors we performed a second clinical study in 124 patients (Study B). Patients scored nasal symptoms on a 1 to 5 points visual analogue scale (VAS) and filled in questionnaires about their comorbidity, previous nasal surgery, and medication use. Results: Study A: There was significant short-term (6-8 weeks after RFA) improvement in nasal obstruction (VAS −1.3, P < .001), trouble exercising (VAS −1.5, P < .001), trouble sleeping (VAS −0.9, P < .001), snoring (VAS −1.1, P< .001), and hyposmia (VAS −0.6, P = .004). Smoking ( R2 = .065, P = .047) was a predictor for less optimized and previous use of decongestive nasal spray ( R2 = .135, P = .005) for better short-term outcome. Study B: Nasal obstruction significantly decreased in the long term (1-5 years after RFA) compared to VAS before RFA (VAS −1.5, P < .001), but slightly increased compared to VAS 6 to 8 weeks after RFA (VAS +0.3, P = .036). Allergy ( R2 = .066, P = .006), asthma ( R2 = .068, P = .005), and previous use of corticosteroid nasal spray ( R2 = .050, P = .016) were associated with a less optimized and older age ( R2 = .217, P < .001) with better long-term outcome. Conclusion: RFA is an efficient treatment for nasal obstruction, and improves sleeping, exercising, snoring, and hyposmia. Predictors for good short-term outcome were previous use of decongestive nasal spray and no smoking. Predictors for a less optimized long-term outcome were allergy, asthma, and previous use of corticosteroid nasal spray. Older age was associated with better long-term outcome.