Microdebrider- assisted turbinoplasty versus coblation Method of turbinoplasty - a comparative study

Abstract

Introduction Inferior turbinate hypertrophy is a major cause of chronic nasal obstruction, significantly impairing nasal airflow and overall quality of life. Although medical management with antihistamines, decongestants, and corticosteroids is the first line of treatment, a subset of patients remains symptomatic and requires surgical intervention. Various surgical techniques, including partial turbinectomy, turbinoplasty, and submucosal tissue reduction, have been developed to improve nasal patency while preserving mucosal function. Microdebrider-assisted turbinoplasty (MAT) and coblation-assisted turbinoplasty (CAT) are two widely used mucosa-sparing techniques. However, limited comparative studies exist evaluating their efficacy, safety, and long-term outcomes. This study aims to compare the clinical outcomes of MAT and CAT in the surgical management of inferior turbinate hypertrophy. Methods This prospective comparative study included 60 patients diagnosed with symptomatic inferior turbinate hypertrophy unresponsive to medical therapy. Patients were randomly assigned to undergo either MAT (n = 30) or CAT (n = 30) under general anesthesia. In the MAT group, a microdebrider was used for submucosal tissue removal and turbinate lateralization, while in the CAT group, controlled radiofrequency ablation was performed using a coblator wand before out-fracturing the turbinate. Postoperative outcomes were assessed using the Nasal Obstruction Symptom Evaluation (NOSE) score and objective airflow measurements at 1 month, 3 months, and 6 months postoperatively. Intraoperative bleeding, postoperative healing, and complications were also evaluated.

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Results Both MAT and CAT showed significant improvements in NOSE scores, with mean scores improving from 72.4 ± 8.6 preoperatively to 18.7 ± 4.2 at 6 months in the MAT group, and from 73.1 ± 7.9 to 19.3 ± 5.1 in the CAT group (p > 0.05). Peak nasal inspiratory flow (PNIF) improved by 62.3% in the MAT group and 58.7% in the CAT group at 6 months (p > 0.05). Intraoperative blood loss was slightly lower in the CAT group (21.5 ± 5.2 mL vs. 27.8 ± 6.4 mL in MAT, p < 0.05). Postoperative crusting and healing times were comparable between the two groups, with no significant difference in complication rates or recurrence of turbinate hypertrophy. Conclusion MAT and CAT are both effective and safe surgical options for managing inferior turbinate hypertrophy. While CAT offers a slight advantage in intraoperative hemostasis, both techniques provide comparable symptom relief, nasal airflow improvement, and mucosal preservation, making either a viable choice based on surgeon preference and patient-specific factors.