Compensatory Inferior Turbinate RFA and Lateralization in Septorhinoplasty: A Randomized Study

To determine whether compensatory inferior turbinate (CIT) intervention performed during septorhinoplasty (SRP) independently improves postoperative nasal airway function and patient-reported symptoms.

Eighty-four patients with nasal obstruction, septal deviation, external nasal deformity, and Grades 2-3 compensatory inferior turbinate hypertrophy were prospectively enrolled. Patients were randomized into two groups: SRP combined with CIT radiofrequency ablation and turbinate lateralization (SRP + IT, n = 42) or SRP alone (SRP, n = 38). Subjective nasal obstruction was evaluated using the Nasal Obstruction Symptom Evaluation (NOSE) scale, while objective nasal airflow was assessed with Peak Nasal Inspiratory Flow (PNIF). Assessments were performed preoperatively and at 6 months postoperatively. Multivariate regression analysis excluding baseline outcome scores was conducted to identify predictors of postoperative improvement.

Both groups demonstrated significant improvement in NOSE scores at 6 months compared with preoperative values (p = 0.001). PNIF values increased postoperatively in both groups. However, no significant differences were observed between the groups in postoperative NOSE score reduction or PNIF gain on the deviated side, turbinate side, or bilateral measurements. When baseline outcome scores were excluded from regression models to avoid floor effect bias, preoperative bilateral PNIF and sex were individually associated with postoperative NOSE improvement, and preoperative NOSE score with PNIF gain; however, neither overall model reached statistical significance (R² = 0.117 and R² = 0.066, respectively). CIT treatment was not an independent predictor of postoperative functional improvement in either model.

Concomitant CIT radiofrequency ablation and turbinate lateralization during SRP does not independently improve postoperative nasal airway function or symptom outcomes. Multivariate analysis excluding baseline outcome scores confirmed that CIT treatment was not an independent predictor of functional recovery. Although preoperative bilateral PNIF and sex showed limited associations with postoperative NOSE improvement, and preoperative NOSE score with PNIF gain, overall model fit was limited in both analyses, suggesting that functional recovery after SRP is multifactorial and not driven by any single clinical variable.

ClinicalTrials.gov Identifier: NCT07481045. The study was retrospectively registered because trial registration was not required by the institutional ethics committee at the time of study initiation.