Inferior nasal turbinate wound healing after submucosal radiofrequency tissue ablation and monopolar electrocautery: Histologic study in a sheep model

Authors

  • Haralampos Gouveris MD, PhD,

    1. Department of Otorhinolaryngology–Head and Neck Surgery, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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  • Christina Nousia MD,

    1. Department of Otorhinolaryngology–Head and Neck Surgery, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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  • Alexandra Giatromanolaki MD, PhD,

    1. Department of Pathology, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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  • Maria Riga MD, PhD,

    1. Department of Otorhinolaryngology–Head and Neck Surgery, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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  • Michael Katotomichelakis MD, PhD,

    1. Department of Otorhinolaryngology–Head and Neck Surgery, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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  • Petros Ypsilantis MD, PhD,

    1. Laboratory of Experimental Surgery and Surgical Research, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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  • Efthimios Sivridis MD, PhD,

    1. Department of Pathology, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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  • Vassilios Danielides MD, PhD

    Corresponding author
    1. Department of Otorhinolaryngology–Head and Neck Surgery, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
    • Department of Otorhinolaryngology–Head and Neck Surgery, Alexandroupolis University Hospital, Dragana, G-68100 Alexandroupolis, Greece
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  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis:

To study differences in inferior nasal turbinate (INT) mucosal and submucosal wound-healing histology after radiofrequency tissue ablation (RTA) and monopolar electrocautery (MEC).

Study Design:

Randomized controlled trial.

Methods:

Experimental study in sheep. Using hematoxylin- and eosin-stained sections, stromal fibrosis, submucosal interstitial space volume (ISV), mucosal epithelial cell necrosis, submucosal inflammation, and vascularization in inferior turbinate samples were compared after RTA and MEC. Twelve turbinate samples were studied for each technique after 1, 3, and 8 weeks postoperatively (four samples at each time point) and there were five samples of controls. A 4-point semiquantitative histologic grading scale (0 = absence, 1 = mild, 2 = medium, 3 = pronounced) was used to assess changes. Comparisons were performed using the Mann-Whitney test and the Kruskal-Wallis one-way analysis of variance (ANOVA).

Results:

At postoperative week 8, the RTA group had more extensive fibrosis (P = .061) and ISV reduction (P = .127), less epithelial cell necrosis (P = .131), and significantly less submucosal inflammation (P = .036) and vascularization (P = .011) compared with the MEC group. Epithelial cell necrosis and submucosal inflammation at week 8 did not differ significantly between RTA and control group (P = 1.000 and P = .356, respectively). A significant decrease in submucosal layer vascularization in RTA-treated INTs has been observed (P = .003 compared with controls).

Conclusions:

RTA is more effective (although not significantly) and less invasive than MEC for INT volume reduction. Tissue damage and wound healing were dominated by inflammation and associated epithelial cell necrosis in MEC and by a disturbance in the INT submucosal microcirculation in RTA in the studied sheep model. Laryngoscope, 2010

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