Radiofrequency Turbinate Reduction Video - 2

Treatment of Hypertrophied Turbinate With RF Device

Nasal turbinates are anatomic structures with three in each nasal cavity. They are responsible for the cleaning, heating and humidification of the air entering the nose by the linear current. Generally, the inferior nasal turbinates are the nasal meats which are most commonly served.

Nasal turbinates can grow due to allergies, recurrent infections, and various structural factors, which is called "turbinate hypertrophy (or nasal concha hypertrophy)". Generally, patients with nasal septum deviation spontaneously enlarge (compensatory hypertrophy) so that the nasal passages in the areas with excess nasal passages are more difficult to enter the excess air and can make treatment, heating, moisturizing treatments.
In patients with nosocomial growth, nasal reduction is recommended in patients with no medical treatment. As in the past, the complete removal of the nose can cause excessive air volume increase in the nose and empty nose syndrome.

Once the nose has shrunk, it can grow again, especially in people with allergic diseases. There are no serious and life-threatening risks other than bleeding among the risks of nose surgery.

Radiofreqency turbinate reduction can be done without a bandage and without a tampon. It can be done in 2-3 minutes on average. Usually painkillers are not needed after the procedure. Applying several patients with moisturizing medication and oceanic water spray to the nose is sufficient.
The price of nasal surgery may vary depending on the hospital and the devices used. In case of using new tissue resistance measuring devices and reducing scaling, the price is increasing.

Radiofrequency reducing or turbinectomy / turbinoplasty

Turbinates can become larger than normal in environmental changes, hormonal changes, upper respiratory tract infections and cause nasal congestion. In this way, the concha can grow in different environments and situations and shrink again with medical treatment or spontaneously.In other words, when turbinates are seen as more hypertrophic or edematous than normal during the examination, it is not appropriate to plan a surgical procedure in the early period.In this way, the turbinate can grow in different environments and situations and shrink again with medical treatment or spontaneously. In other words, when turbinates are seen as more hypertrophic or edematous than normal during the examination, it is not appropriate to plan a surgical procedure in the early period. Procedures such as a turbinectomy or turbinoplasty, which are to be removed by excision of the turbinate tissue itself or to reduce its content by preserving the mucosa, should be avoided as much as possible, as they mean a permanent tissue change, may cause a serious reduction in turbinate functions, and may cause the risk of empty nose syndrome and nasal hyperventilation. are necessary procedures. Repeated radiofrequency applications cause less change in turbinate structure and minimal mucosal damage occurs when tissue resistance measuring devices are used. In Turbinectomy or turbinoplasty procedures; the structure of the tirbinate is permanently changed and reduced.

Radiofrequency Turbinate Reduction Indications

When there is turbinate hypertrophy, if shrinkage cannot be achieved with medical treatment, if exercise capacity and sleep quality decrease, sleep with the mouth open, and nasal congestion in general become permanent, this procedure can be planned.

Radiofrequency turbinate reduction (RFTR) is a medical procedure used to treat nasal congestion and other symptoms associated with turbinate hypertrophy. The procedure involves using radiofrequency energy to reduce the size of the nasal turbinates, which are structures inside the nasal passages that help regulate airflow and humidity. RFTR is typically considered when conservative treatments have failed to provide sufficient relief or when turbinate enlargement significantly affects a person's quality of life.

Here are some indications for considering radiofrequency turbinate reduction:

1. Chronic Nasal Congestion: Nasal congestion that persists for an extended period, despite medical management, can be an indication for RFTR. Turbinate hypertrophy, where the nasal turbinates become enlarged and obstruct the nasal passages, is a common cause of chronic nasal congestion. RFTR can help reduce the size of the turbinates, thereby improving airflow and reducing congestion.

2. Allergic Rhinitis: Individuals with allergic rhinitis, commonly known as hay fever, often experience nasal congestion as a result of inflamed and swollen nasal turbinates. When symptoms are not adequately controlled with medications such as antihistamines or nasal sprays, RFTR may be considered as a treatment option to alleviate nasal congestion and improve overall breathing.

3. Non-Allergic Rhinitis: Non-allergic rhinitis refers to nasal inflammation and congestion that occurs without an allergic trigger. This condition can be caused by various factors such as changes in temperature, humidity, irritants, or underlying nasal conditions. When non-allergic rhinitis leads to significant turbinate hypertrophy and persistent symptoms, RFTR can help reduce the size of the turbinates and provide relief.

4. Nasal Obstruction: Turbinate hypertrophy can lead to nasal obstruction, making it difficult to breathe through the nose. This can significantly impact sleep quality, exercise tolerance, and overall daily activities. If nasal obstruction persists despite conservative treatments, RFTR may be considered to address the underlying cause of the obstruction and restore normal nasal airflow.

5. Nasal Polyps: Nasal polyps are noncancerous growths that can develop in the nasal passages and cause nasal congestion, reduced sense of smell, and other related symptoms. In cases where turbinate hypertrophy coexists with nasal polyps, RFTR can be performed to reduce the size of the turbinates and improve nasal airflow, enhancing the overall management of the condition.

It's important to note that the decision to undergo radiofrequency turbinate reduction should be made in consultation with an ENT (Ear, Nose, and Throat) specialist or a qualified healthcare professional. They will assess the individual's symptoms, conduct a thorough examination, and determine whether RFTR is an appropriate treatment option based on the specific circumstances and severity of the condition.

While RFTR is generally considered a safe and minimally invasive procedure, potential risks and benefits should be discussed with a medical professional to ensure appropriate expectations and a comprehensive understanding of the treatment process.

Radiofrequency Turbinate Reduction Cost

The cost of the procedure may increase if devices that measure tissue resistance are used and not performed under general anesthesia. Generally, the total transaction cost can vary between 1750 - 2500 US Dollars, depending on hospital conditions. The cost of the procedure under office conditions and under local anesthesia varies between 500-1000 US Dollars. The cost of the procedure may be slightly higher when septoplasty, nose tip plasty or rhinoplasty operation is performed together with Turbinate RF.

The cost of radiofrequency turbinate reduction (RFTR) can vary depending on several factors, including the geographical location, the specific medical facility or clinic, the surgeon's expertise, and any additional fees associated with pre-operative assessments, anesthesia, and post-operative care. It is important to consult with healthcare providers or medical facilities to obtain accurate and up-to-date information regarding the cost of the procedure.

As a rough estimate, the cost of RFTR can range from several hundred to a few thousand dollars per nostril. However, it's important to note that this estimate is subject to variation and may not reflect the actual cost in every case. Different healthcare systems and insurance coverage can also influence the out-of-pocket expenses for the procedure.

Factors that can influence the cost of RFTR include:

1. Geographic Location: The cost of medical procedures can vary significantly depending on the country, state, or city in which the treatment is performed. In areas with higher costs of living, medical expenses may also be higher.

2. Medical Facility and Surgeon: The reputation, expertise, and experience of the medical facility and surgeon can affect the overall cost of the procedure. Highly experienced and renowned surgeons or specialized clinics may charge higher fees for their services.

3. Additional Fees: In addition to the actual procedure, there may be additional costs associated with pre-operative assessments, anesthesia, facility fees, and post-operative care. These fees should be considered when determining the overall cost of RFTR.

4. Insurance Coverage: Depending on the specific insurance plan and coverage, some or all of the expenses related to RFTR may be covered. It is important to consult with the insurance provider to understand the extent of coverage and any associated out-of-pocket costs.

It is advisable to consult with multiple healthcare providers or clinics to obtain a comprehensive understanding of the costs involved. They can provide detailed information on the specific services included in the quoted price and any potential additional expenses.

Furthermore, it's important to prioritize the expertise and quality of care provided by the surgeon and the medical facility when considering RFTR, as the procedure's success and the patient's well-being should be the primary concerns.

Postoperative Care After Radiofrequency Turbinate Reduction

After the procedure, it is normal for blood to come from the front and back of the nose for the first few days, and to leak blood in the form of dripping and leaking. It is appropriate to avoid exercise activities that will increase blood pressure for the first 10 days. It is not appropriate to consume salty, spicy, extremely hot foods by mouth in the first few weeks. If a nasal packing is not used after the procedure, it may be necessary to be more careful in terms of bleeding. Exercises such as bending down and lifting weights or lifting weights should be interrupted for a few weeks. Generally, after the procedure, it is beneficial to wash the nose with an ocean water spray and use intranasal mucosa moisturizing products. Generally, the total recovery period is around 2 months, and it is useful to clean the inside of the nose with seawater sprays during this period. Bathing with normal city water can be started after 3 weeks. For the first 2 weeks, it is appropriate to lie down with an inclination of 45 degrees during sleep. Blowing and sneezing with the mouth closed are inconvenient for the first 2 weeks.

Radiofrequency Turbinate Reduction Complications

Complications can occur with any procedure. Although it is a relatively simple surgical procedure, the following complications may occur after Turbinate reduction:

- bleeding
- local mucosal infections and cankering into the nose

Nasal hyperventilation and empty nose syndrome may occur as a result of persistent adverse changes in turbinate volume and structure (shrinkage and excessive fibrosis occurrence) when excessive amounts of radiofrequency energy are given (when tissue resistance measuring devices are not used).
- Intranasal mucosal adhesions (nasal synechia) occur especially when a tampon that acts as an intranasal barrier is not used.

When Turbinate RF reduction is done correctly and in a limited amount, the above complications are almost non-existent.

How many days do nosebleeds continue after turbinate radiofrequency?

After the procedure, nosebleeds are in the form of dripping and leaking for the first 3 days; After 3 days, the nosebleed usually starts to decrease and after the 10th day it becomes almost non-existent. During the first 10 days, it is appropriate to avoid exercises where the head level may be below the heart, and to avoid exercises such as heavy lifting that may cause a serious increase in blood pressure. It is beneficial to avoid products with blood thinning properties such as aspirin, garlic, ginkgo biloba, fish oils and sour cherries.

Will there be a shape change in the nose after turbinate radiofrequency?

Turbinates are tissues in the nose that shape the intranasal airway. It has no direct connection with the structures forming the outside of the nose. After the procedures for turbinates, there is no change except for the nose. Due to the tampons placed in the nose, the nose may appear larger and wider than it is. This situation is also passable.

Radiofrequency turbinate reduction side effects

When turbinate radiofrequency is used in limited amounts and devices that minimize mucosal damage are used, side effects are very few. However, after repeated and excessive amount of energy turbinate ablations with radiofrequency, excessive reduction in turbinate volumes, permanent tissue loss, decreased blood supply to the turbinates, and the emergence of excessive fibrotic small turbinates, such as Empty Nose Syndrome, Nasal Hyperventilation, intranasal crusting, bleeding and drying. Conditions and problems such as persistent symptoms, drying and crusting in the lower respiratory tract, air hunger when breathing, and the appearance of painful points in the nose can be seen. Nose bleeding may occur in the early post-procedure period. Turbinates should be considered as organs and a limited amount of processing is required.

What is the safest method of turbinate reduction?

In the treatment of turbinate hypertrophy, the most commonly used method with the least possibility of side effects is turbinate reduction with radiofrequency. There is a higher risk of permanent tissue damage and negative permanent changes in nasal functions in methods such as turbinectomy, turbinoplasty, and turbinate lateralization. Again, mucosal damage may be more in turbimnate ablation with laser.

Do turbinates grow back after radiofrequency reduction?

After turbinate reduction with radiofrequency, in case conditions that may cause hypertrophy in turbinates continue (allergen exposure, breathing in polluted air, recurrent upper respiratory tract infections, contact with nasal irritant gases, hormonal changes, drug use ...), the turbinates may regrow over time and the nose may grow back. may cause congestion. Generally, after turbinate ablation with radiofrequency, the turbinates start to grow back after 1 year. This period can become more girlish when there is more than one factor.

What is the alternative to turbinate radiofrequency reduction?

Various drugs (cortisone nasal sprays, allergy medications, decongestants) can be used for turbinate reduction. This medical treatment is not as effective as radiofrequency. In addition, direct surgical procedures can be performed on turbinates, such as turbinectomy and turbinoplasty, but the risk of side effects is higher.

Can turbinate hypertrophy affect smell?

In cases such as septum deviation, turbinate hypertrophy or nasal polyp, which cause a decrease in the nasal air passage, the amount of air entering the odor detection area in the nose will decrease, and a decrease in the sense of smell occurs. Conversely, turbinate reduction can have a positive effect on olfaction.

What is the most effective turbinate reduction?

You should think twice before asking this question to your doctor! First of all, I would like to reiterate that turbinates are unique tissues and are responsible for making the intranasal air suitable for the lungs. By combining methods such as submucosal resection, lateral displacement of turbinates, microdebrider-assisted submucous reduction, which have been defined in the treatment of turbinate hypertrophy, the reduction in turbinate volume can be made greater. Already when the first process was defined, that is, applications such as weaving the demies into the nose centuries ago and removing the turbinates by evaporation were reported. All structural details such as turbinate mucosal cover, cilia structure, volume, and the unique capillary circulation network inside are very important, and minimal anatomical changes and minimal trauma should be aimed when reducing turbinates. Turbinates can be cut and removed in a few seconds with just a simple bone scissors, but please be informed before the procedure about the empty nose syndrome and symptoms you may experience afterwards!

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Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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