Clin Exp Otorhinolaryngol.  2023 May;16(2):141-147. 10.21053/ceo.2022.01312.

High-Intensity Focused Ultrasound Therapy Versus Coblation for the Treatment of Inferior Turbinate Hypertrophy: A Clinical Trial

• Kim HG
• Kim DS
• Choi YS
• Lee ES
• Yoo HJ
• Kim DY

• KMID: 2542355
• DOI: http://doi.org/10.21053/ceo.2022.01312

Abstract

Objectives
. To compare the efficacy and safety of high-intensity focused ultrasound (HIFU) therapy with coblation for the treatment of inferior turbinate hypertrophy (ITH).
Methods
. In this randomized controlled clinical trial, 20 patients underwent inferior turbinate surgery, which consisted of either HIFU or coblation therapy. Efficacy, safety, and tolerability were evaluated by subjective symptom scores, acoustic rhinometry, and nasal endoscopy.
Results
. The modified nasal obstruction symptom evaluation (NOSE) score and nasal obstruction visual analog scale (NO-VAS) significantly decreased in both groups 12 weeks postoperatively. The between-group differences in the evaluation scores were not statistically significant. On nasal endoscopy, the HIFU patients showed improvements in mucosal swelling sooner than the patients undergoing coblation therapy. Nasal crusting significantly increased in the patients undergoing coblation compared to the patients undergoing HIFU therapy until postoperative week 4. Mucosal preservation was superior in the HIFU patients. Although HIFU was less painful than coblation therapy during the procedure, the difference was not significant (4.9 vs. 6.3, P=0.143). The difference in global satisfaction between the two groups was not statistically significant, although satisfaction was slightly higher among the HIFU patients than among the coblation patients (4.6 vs. 4.1, P=0.393).
Conclusion
. HIFU provided results similar to those of coblation therapy for patients with nasal obstruction due to ITH, but HIFU therapy caused less discomfort during the procedure. HIFU therapy appears to be a good noninvasive alternative to the current surgical modalities for ITH.

Keyword

High-Intensity Focused Ultrasound; Turbinates; Hypertrophy; Nasal Obstruction; Radiofrequency Ablation

Figure

• 

  Fig. 1 (A) The Rhin-Hi system. (B) Probe of the Rhin-Hi system. (C) High-intensity focused ultrasound procedure under nasal endoscopic guidance.

• 

  Fig. 2 Preoperative and postoperative nasal endoscopy examinations. High-intensity focused ultrasound (HIFU; A–D) and coblation (E–H). (A, E) Preoperative nasal endoscopy. (B, F) Endoscopy at postoperative week 2 showed that both HIFU and coblation reduced the volume of the inferior turbinate. Severe crust formation and mild bleeding were observed in the coblation patients, whereas the mucosal layer was completely preserved in the HIFU patients. (C, G) Nasal endoscopy at postoperative week 4. Residual crust was observed, indicating delayed mucosal recovery in the coblation patients. (D, H) The volume of the inferior turbinate was reduced in both groups, and the mucosa had recovered in the coblation patients at postoperative week 12.

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