Efficacy and Safety of Inferior Turbinate Coblation-Channeling in the Treatment of Nasal Obstructions

The aim of this study was to evaluate the safety and effectiveness of coblation-channeling in the treatment of inferior turbinate hypertrophy. The study was conducted in the Department of ENT, Head and Neck Surgery, Split University Hospital Center, Split, Croatia. Fifty-two patients with inferior turbinate hypertrophy who were refractory to medical therapy were evaluated for coblation. The procedures were performed under local anesthesia using an ArthroCare ReFlexUltra 45 wand; three submucosal channels were made per turbinate. Clinical examinations, a questionnaire on individual nasal symptoms (hyposmia, nasal drainage and post-nasal drip), a 10-cm visual analog scale (VAS) grading general nasal obstructions, and rhinomanometry before and 8 weeks after the treatment were administered to assess treatment outcomes. No adverse effects were encountered. Nasal breathing was significantly improved in all patients, decreasing the VAS from a median of 7 (range 2–9) to 1 (range 0–3) (p<0.001). Total nasal resistance decreased from 0.44 Pa±0.50 to 0.24 Pa±0.11 (p=0.005). Improvement was statistically significant for all three symptoms (hyposmia [p=0.005], nasal drainage [p=0.003] and post-nasal drip [p<0.001]). In this paper, we demonstrate that coblation-channeling of the hypertrophic inferior turbinate is an effective and safe way to reduce nasal obstruction symptoms

Efficacy and Safety of Inferior Turbinate Coblation-Channeling in the Treatment of Nasal Obstructions

The aim of this study was to evaluate the safety and effectiveness of coblation-channeling in the treatment of inferior turbinate hypertrophy. The study was conducted in the Department of ENT, Head and Neck Surgery, Split University Hospital Center, Split, Croatia. Fifty-two patients with inferior turbinate hypertrophy who were refractory to medical therapy were evaluated for coblation. The procedures were performed under local anesthesia using an ArthroCare ReFlexUltra 45 wand; three submucosal channels were made per turbinate. Clinical examinations, a questionnaire on individual nasal symptoms (hyposmia, nasal drainage and post-nasal drip), a 10-cm visual analog scale (VAS) grading general nasal obstructions, and rhinomanometry before and 8 weeks after the treatment were administered to assess treatment outcomes. No adverse effects were encountered. Nasal breathing was significantly improved in all patients, decreasing the VAS from a median of 7 (range 2–9) to 1 (range 0–3) (p<0.001). Total nasal resistance decreased from 0.44 Pa±0.50 to 0.24 Pa±0.11 (p=0.005). Improvement was statistically significant for all three symptoms (hyposmia [p=0.005], nasal drainage [p=0.003] and post-nasal drip [p<0.001]). In this paper, we demonstrate that coblation-channeling of the hypertrophic inferior turbinate is an effective and safe way to reduce nasal obstruction symptoms

Indications de la technique de coblation en chirurgie des tissus mous

La technique de Coblation est une technique d'ablation controlée des tissus à basse température, brevetée par la société ArthroCare Corporation en 1997. L'énergie de la radiofréquence bipolaire est transmise à une solution saline afin de créer un plasma ionisé. Dans des conditions spécifiques, la solution saline se vaporise à proximité immédiate des électrodes actives, formant une fine couche de vapeur. le plasma résultant produit des éléments qui interagissent avec le tissu voisin : ce dernier est incisé ou éliminé. Trés répandue en chirurgie humaine, notamment pour traiter des affections articulaires et de la colonne vertébrale, son développement en oto-rhino-laryngologie a été plus tardif. La médecine vétérinaire a récemment adapté la Coblation en chirurgie orthopédique. Cependant, son utlisation en chirurgie des tissus mous reste aujourd'hui très limitée. Dans la première partie de cette revue bibliographique, le principe de fonctionnement de la Coblation, le matériel utilisé, ainsi que les avantages et inconvénients de cette technique sont présentés. Les indications humaines en chirurgies des amygdales, du voile du palais, des cavités nasales, de la langue, l'oncologien et la cosmétologie sont évoquées et argumentées. Enfin, 5 animaux traités par Coblation à l'Ecole Nationale Vétérinaire de Toulouse illustrent quelques-unes des plus fréquentes indications