Four (more) ways to reduce turbinates
Reviewed by Joanne Rimmer

Setting aside the issue of when/if to reduce inferior turbinates, the issue of how to reduce turbinates is a never-ending story. This edition of rhinology carries two articles looking at this subject, both prospective randomised trials comparing two different methods – four (more) ways to skin a turbinate. Hegazy et al compared coblation in 40 patients with the microdebrider in 30, over a six month follow-up period. Kisser et al compared laser diode and radiofrequency treatment in 26 patients, randomising each patient to receive laser on one side of the nose and radiofrequency on the other; follow-up was three months. Nasal symptoms, as rated by visual analogue scores (VAS), improved significantly following surgery in all patients, with no difference between the treatments in each study. Postoperative pain was significantly worse in the microdebrider group (compared to coblation) and the radiofrequency side (compared to the laser side). There was no significant difference in complications between the treatment modalities in each study, although bleeding occurred in 77% of turbinates treated with radiofrequency (compared to none with the laser). Kisser et al also compared objective measures including acoustic rhinometry and rhinomanometry, and found no difference between treatments (or, indeed, before and after treatment). Interestingly, although radiofrequency was more painful than laser, 50% of patients would have radiofrequency treatment repeated compared to only 23% for the laser; 19% would have both again and 8% neither. So all four treatment modalities resulted in a significant improvement in subjective nasal symptoms, with no difference between them in each study. The search for the most effective method of turbinate reduction continues... 

Inferior turbinate reduction; coblation versus microdebrider – a prospective, randomised study.
Hegazy HM, El Badawey MR, Behery A.
RHINOLOGY
2014;52(4):306-14.

Diode laser versus radiofrequency treatment of the inferior turbinate – a randomized clinical trial.
Kisser U, Stelter K, Gurkov R, et al.
RHINOLOGY 2014;52(4):424-30.