2114 Inferior tribunate reduction by radiofrequency improves pulmonary function

Monday, 8 December 2014
Exhibition Hall-Poster Area (Sul America)

Mufide Arzu Ozkarafakili, MD , Pulmonary Department, Sisli Hamidiye Etfal Hospital, ISTANBUL, Turkey

Background: Inferior Tribunate (IT)  reduction by radiofrequency ablation improves pulmonary function.

Methods: The study was conducted on 19 patients with symptoms of nasal obstruction associated with Inferior Tribunate Hyperthrophy bilaterally for 6 months, failed to respond  to a 3 months therapy of steroids & systemic decongestants. Additional excluding criteria included Systemic Corticosteroid, Teophyllin, Anticholinerjic, Antileukotrien, Nedokromil, Anticoagulan use.The patients whose pathologies found by anterior rhinoscopy and nasal endoscopy inspections; septal deviation, nasal polyposis, obstruction in nasal valve, alar collapse, middle tribunate hypertrophy, and the patients had nasal surgery or septal perforation are also exempted.Subjective symptoms including severity of nasal obstruction were measured by a standard, 10cm Visual Analog Scale(VAS). A score of 0 no obstruction and a score of 10 indicated severe nasal obstruction. Data obtained for each Nasal Cavity by Acoustic Rhinometry(AR) before and 6 weeks after IT RF. Postop evaluations were made in week 6.The RF Equipment used were CelonLabENT, Celon AG.All patiens were checked postop week 1&6. Pulmonary Function Tests (PFT)including FVC, EV1, PEF, FEV1/FVC values evaluated according to  American Thoracic Society criteria. For statistical evaluation of datas; Std. Deviation, Mean (Avg), Min, Max&Median values used. Paired-Samples"t", Kolmogorov Smirnow and Wilcoxon tests used for repeating measurements.Analysis computed by SSPS 21.0 S/W.

Results: 38 L&R IT analysed after RF applied, VAS values retrieved by t test.Postop week 6 VAS values compared with Preop, significant improvement(p<0,05) obtained. Mean Cross-section Area of 1&2 (MCA1, MCA2) and R, L  VOLumes and (totVOL) were evaluated.Significant (p<0,05) increase observed in postop values of L/R, 1/2 and total volumes. Preop and Postop comparison of PFT results of FVC and FEV1 values showed significant increase (p<0,05), unlikely FEV1/FVC & PERF increases were not significant (p>0,05).

Conclusions: Evaluation of RF trubinate ablation with AR measurements showed a significant increase in nasal flow and significant decrease in decongestion effects. Small scale changes in the tribunate provided improvement in the symptoms through increasing of airflow in the nasal valve and resulted in positive PFT changes. Correction of the obstruction of the IT caused by hyperthropy by RF ablation, individually eased breathing resulting in improving pulmonary function.