“This study adds significant weight to the argument that RF treatments with Coblation aimed at the inferior turbinates are ineffective long term and put the patient’s nasal mucosa at risk,” says Scott Carpenter, senior product manager for ENT Powered Systems, part of the Surgical Technologies business at Medtronic.

In the study, 120 patients with chronic nasal obstruction and persistent allergic rhinitis unresponsive to medical treatment were randomly assigned to receive either microdebrider-assisted inferior turbinoplasty (MAIT) with the Medtronic device or radiofrequency-assisted inferior turbinoplasty (RAIT) with Coblation (ArthroCare Corporation). There were also 10 patients with no symptoms of nasal obstruction who served as normal controls. Patients were evaluated preoperatively and at six months and at one, two, and three years postoperatively using standardized measurements. These consisted of a visual analogue scale of 0 to 10 to gauge the patient’s subjective symptoms (nasal obstruction, rhinorrhea, sneezing, and snoring), active anterior rhinometry to measure total nasal resistance (obstruction), and saccharin testing to assess nasal mucociliary transport (how well the nasal mucosa are functioning by how long it takes for a patient to experience a sweet taste after a saccharin granule is placed in the nose).

The study found that, compared with preoperative findings, subjective and objective measurements in the MAIT group had improved significantly at all postoperative assessment times. In the RAIT group, significant improvements were observed at six months and one year, but not at two and three years. When results in the two groups were compared, none of the values for the assessed variables were significantly different at six months. At one, two, and three years, however, all results for both the subjective and objective variables were significantly better in the MAIT group. Neither group experienced significant complications from surgery.

The powered inferior turbinoplasty technique can be performed using the Medtronic Straightshot M4 Microdebrider and Inferior Turbinate Blade with patented elevator tip. Manufactured by the ENT business at Medtronic and available in the US, this system features a tiny, rotating tip that allows the surgeon to remove tissue more precisely than traditional surgery tools. Using the Medtronic microdebrider, surgeons can remove enough tissue to correct the nasal obstruction and relieve the patient’s symptoms while preserving the mucous lining and normal turbinate function. Preservation of mucosa is considered an important factor in better postoperative outcomes in patients who have undergone nasal surgery.

The long-term results of this study are also supported by findings from Berger et al, Lee et al, and Sacks et al.

“Because surgery is more invasive than medical treatment, it is important that surgery result in sustained improvements in the patient’s quality of life. Thus, we compared the long-term efficacies of the two surgical techniques,” writes Liu. “MAIT is more effective than RAIT for relieving nasal symptoms and decreasing total nasal resistance and saccharin transit time one to three years postoperatively in patients with persistent allergic rhinitis who have substantial nasal obstruction.”