What Is Radiofrequency Turbinate Reduction?
Radiofrequency turbinate reduction is a procedure that is done to reduce the size of the turbinates. The turbinates are the structure inside the nose that humidifies and purifies the air that enters the nose, which is passed on to the lungs. They are bony structures that are surrounded by vascular structures and covered by mucous membranes. These turbinates get inflamed and swollen during infections or irritation, which will cause excess production of mucous that causes nasal obstruction and nasal congestion. Radiofrequency turbinate reduction procedure uses a needle-like instrument that uses heat produced by radio waves to cause controlled damage to the turbinates, so by the time the wound heals, the size of the turbinates will be reduced, which will allow better airflow through the nose.
What Are the Symptoms of Turbinate Hypertrophy?
The symptoms of turbinate hypertrophy are as follows:
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Difficulty in breathing.
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Nasal congestion.
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Nasal blockage.
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Nasal stuffiness while lying down.
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Mouth breathing while sleeping.
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Increased nasal drainage.
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Noisy breathing.
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Nasal congestion affects the alternate sides of the nose.
What Are the Indications for Radiofrequency Turbinate Reduction?
Radiofrequency turbinate reduction can be used for the following cases:
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Nasal congestion is associated with inferior turbinate mucosal hypertrophy.
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In patients who are undergoing treatment for rhinitis medicamentosa.
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For patients who suffer from sleep apnea with increased nasal resistance.
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Patients with a deviated nasal septum and nasal congestion with inferior turbinate mucosal hypertrophy.
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Patients with inferior turbinate mucosal hypertrophy who have undergone septoplasty, rhinoplasty, or endoscopic sinus surgery.
What Are the Contraindications for Radiofrequency Turbinate Reduction?
There are no absolute contraindications for doing radiofrequency turbinate reduction. This procedure cannot be done for patients who have heart pacemakers or other electronic devices unless they are temporarily deactivated. Also, patients with other comorbidities, such as hypertension and diabetes mellitus, should get prior consent from their respective physicians before undergoing this procedure. The patients on anticoagulants should stop them for at least 72 hours prior to the surgery.
The factors which have an impact on the success rate of this procedure include the following:
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Severe nasal deformity.
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Severe septal deformity.
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Acute allergic rhinitis.
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Acute infectious rhinitis.
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Ongoing respiratory infection.
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Internal or external valve collapse.
What Can I Expect After the Radiofrequency Turbinate Reduction Procedure?
There can be fullness of the nose, and bleeding can be there for 48 to 72 hours after the procedure. The breathing will be better when compared to before the procedure. However, the healing can take around six to eight weeks, so the improvement will not be visible right after the surgery; it will happen gradually.
How Will I Take Care of the Nose After Radiofrequency Turbinate Reduction Procedure?
The following things should be taken care of following the surgery, and they are:
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Sleep with the head at an elevated position during the night following the procedure.
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Use nasal rinse around six to eight times a day.
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Refrain from blowing the nose or sneezing for at least two weeks following the surgery.
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From the third week after the procedure, blow the nose gently as there will be crusting on the nose.
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Use the CPAP (continuous positive airway pressure) machine to have proper airflow through the nose.
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Place a gauze piece under the nose so that any drainage will be collected in it while lying down. Change it frequently for the initial two to three days.
When Is Turbinate Reduction Necessary?
Turbinate reduction is indicated when the turbinates are enlarged to an extent to affect the other portions of the nose and the airway resulting in disorders such as sleep apnea, congestion, post-nasal drip, and difficulty in breathing.
Is Radiofrequency Turbinate Reduction Safe?
Radiofrequency turbinate reduction procedure is a safe surgical procedure that will reduce the size of the turbinates without altering the nasal mucosa and causing minimal discomfort to the patient.
How Is Radiofrequency Turbinate Reduction Done?
Radiofrequency turbinate reduction procedure is usually done when the patient is awake by giving local anesthetics. When this procedure is done along with other procedures, it is done under general anesthesia. The equipment which is used is topical and local anesthetics, cable, syringe, dispersive electrode, handpiece, needle, gauze, and nasal pledgets. When the procedure is done in an in-office setup, position the patient in a comfortable seating position with the dispersive electrode placed over a well-vascularized muscular site with complete contact with the skin. No separate seating positions are required when the procedure is done, along with other procedures.
Insert the needle electrode into the inferior turbinate into the middle portion of the turbinate with a specific set voltage, current, and temperature per lesion. This activated system takes around one to two minutes per lesion. The time per lesion can be decreased by increasing the energy levels, which can be done under general anesthesia only. The needle is introduced to a depth of five millimeters to avoid the risk of damaging the mucosa resulting in ulceration or sloughing.
When to Call the Doctor?
Consult with a doctor when for the following:
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When there is extreme swelling and bruising in the middle third of the face.
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Even after taking the medications for pain, the pain is not relieved.
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When there is a fever in the days after the surgery.
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When there is bleeding from the nose that does not stop even after applying pressure for about 20 minutes in an upright sitting position with the head bent forward.
What Kind of Activity Can One Do After the Procedure?
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One can do all the activities which will not elevate the blood pressure. Do not lift items that are heavy for the initial week following the procedure.
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One can resume work in a sitting position 24 hours after the surgery.
Conclusion
Radiofrequency turbinate reduction is an in-office procedure that is done to reduce the size of the turbinates in case of turbinate hypertrophy, which can lead to nasal congestion, obstruction, and increased nasal discharge, which will affect the day-to-day living of the patient. Hence, a radiofrequency turbinate reduction is a cure for this condition. The procedure is done under local anesthesia when done in an in-office setup or with other procedures then general anesthesia is given.
