Radiofrequency Ablation for Inferior Turbinate Hypertrophy: Predictors of Failure and Outcomes of Revision Treatment

Radiofrequency ablation (RFA) is a mucosal-sparing, in-office technique for inferior turbinate hypertrophy (ITH) with favorable short-term outcomes. Data regarding the efficacy of revision RFA in patients with treatment failure are limited.

To identify predictors of RFA failure requiring revision and to evaluate the safety and efficacy of revision RFA.

A retrospective cohort study was conducted, including patients with ITH who underwent RFA between 2016 and 2023 at a tertiary referral center. Patients requiring revision treatment were identified and compared with those who did not require revision.

The cohort included 260 patients (66.9% male; age range, 18-88 years). Thirty-three patients (12.7%) required revision treatment, of whom 24 (9.2%) underwent revision RFA. No post-revision RFA complications were observed. The overall revision rates were higher among older patients (P = .015), patients with medical comorbidities (P < .001), and those with middle turbinate hypertrophy (P = .047). Short-term revision (<6 months) was more common among patients with diabetes (P < .001) and obstructive sleep apnea (OSA; P = .012), while revision in the long term (<24 months) was associated with diabetes (P < .001), hypertension (P = .019), and rhinitis medicamentosa (P = .045). On multivariate Cox proportional hazards analysis, diabetes mellitus, OSA, and rhinitis medicamentosa were independently associated with an increased risk of revision for both short and long term.

Revision RFA is a safe and effective treatment option for selected patients with recurrent nasal obstruction due to ITH. Higher revision rates were observed in older patients and those with medical comorbidities and rhinitis medicamentosa. Revision RFA should be considered as a conservative second-line treatment in appropriately selected patients.