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Radiofrequency ablation for inferior turbinate hypertrophy in patients with rhinitis medicamentosa
Narin N Carmel-Neiderman1, Ran Bilaus1, Nidal Muhanna1
1Tel Aviv University, School of Medicine, Tel Aviv Sourasky Medical Center, Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv, Israel.
Objectives:
Nasal airway obstruction is commonly associated with Inferior Turbinate Hypertrophy (ITH), often stemming from chronic inflammation. Rhinitis Medicamentosa (RM), a type of non-allergic rhinitis, is frequently linked to prolonged use of nasal decongestants. We investigated Radiofrequency Ablation-assisted Turbinate Reduction (RFATR) as a second line in office treatment for RM, focusing upon its impact on decongestant spray cessation and Quality of Life (QoL).
Methods:
A prospective cohort study at a tertiary university-affiliated medical center. Consecutive adult patients with nasal airway obstruction and Inferior Turbinate Hypertrophy (ITH) who underwent Radiofrequency Ablation of the inferior Turbinates (RFATR). Patients were categorized into two groups: those with Rhinitis Medicamentosa (RM) and those without RM. The main outcome measures were cessation of nasal decongestant abuse, perioperative complications, and patient-reported responses to Quality-of-Life (QoL) questionnaires.
Results:
Fifty-three of the 256 patients who underwent RFA between March 2016 and March 2023 at our medical center were diagnosed as having RM. RM patients had a higher mean age and more comorbidities than non-RM patients. RM patients achieved significant improvements in He-NOSE questionnaires post-RFATR compared to non-RM patients (pre- and postoperative score difference of 11.9 ± 5.8 vs. 5.7 ± 6, respectively, p = 0.002). All RM patients ceased using decongestant spray use following RFATR. Complication rates and need for revision were low, with no significant group differences.
Conclusions:
RFATR is an effective and safe treatment for RM, significantly improving patients' QoL and facilitating decongestant spray cessation. Its minimal invasiveness, ease of administration, and compatibility with local anaesthesia make it a viable option for ceasing decongestant spray abuse with potential long-term benefits.
Level Of Evidence:
Level 3 evidence, according to the Oxford Centre for Evidence-Based Medicine 2011.
