RadioFrequency Ablation of Septal Swell Body

Introduction: Anatomic etiologies of nasal obstruction (NO) include septal deviation, turbinate hypertrophy, and nasal valve collapse. We have also noted that nasal septal swell bodies (NSB) are extremely common and can produce a significant effect on nasal resistance. The aim of our study was to explore changes in validated outcome metrics after surgical reduction of NSB. Methods: 60 consecutive patients (38 M: 22 F) were enrolled after persistent nasal obstruction following septoplasty, turbinate reduction and internal nasal valve repair. Clinical history and nasal endoscopy confirmed prominent NSB. Evaluation of treatment effect was determined by changes in the NOSE scale and a newly developed NSB grading scale before, and six months after swell body ablation in the officesetting using radiofrequency. NSB grades were based on endoscopic visualization of the middle turbinate (MT): 1= > 50% MT visualized; 2 = < 50% MT visualized; 3 = no MT visualized. Patient data was scored and transferred for analysis using Prism6 Graph Pad software. Results: The 60 patients in our study had a mean age of 48 years (range 1971) and were followed for 3 and 6 months. The mean pre-operative NOSE score was 41.6 and mean NSB grade was 2.5. At 3 months, the mean post-operative NOSE score was 17 with NSB grade of 1. At 6 months, the NOSE score was 21 and the NSB grade was 1.2 (p<.05). Thus, statistically significant improvement in NOSE scores and standardized NSB grading was noted at 3 and 6 months post coblation of NSB tissue. There was one asymptomatic small septal perforation noted, and 5 patients needed retreatment at 6 months. Conclusions: Coblation reduction of NSB is a safe and very effective new officebased treatment option for the correction of refractory nasal obstruction.