4 Efficacy

4 Efficacy

This section describes efficacy outcomes from the published literature that the Committee considered as part of the evidence about this procedure. For more detailed information on the evidence, see the overview.

4.1

In a randomised controlled trial of 120 patients treated by radiofrequency or microdebrider-assisted turbinoplasty, mean visual analogue scale scores (ranging from 1 to 10, with lower scores indicating better outcomes) for nasal obstruction, sneezing, rhinorrhoea and snoring improved from 8.5 to 1.5, 6.0 to 1.8, 6.6 to 1.7 and 6.6 to 1.6 respectively in the radiofrequency group at 6‑month follow-up (p values <0.05). In the microdebrider group, mean visual analogue scale scores for nasal obstruction, sneezing, rhinorrhoea and snoring improved from 8.7 to 1.4, 6.2 to 1.7, 7.0 to 1.6 and 6.7 to 1.6 respectively (p values <0.05). No statistically significant differences in visual analogue scale scores were observed between the 2 treatments at 6‑month follow-up. At 3‑year follow-up, mean visual analogue scale scores for nasal obstruction, sneezing, rhinorrhoea and snoring were 8.3, 5.6, 6.5 and 6.2 in the radiofrequency group and 1.6, 1.9, 1.7 and 1.8 respectively in the microdebrider group. All inter-group comparison p values were less than 0.05.

4.2

In a randomised controlled trial of 50 patients treated by radiofrequency-assisted turbinoplasty or traditional surgery, mean scores for endoscopic evaluations of turbinate oedema (scores ranged from 0 to 4 with lower scores indicating better outcomes) decreased from 2.6 to 0.6 and from 2.5 to 0.6 respectively at 3‑month follow-up (p values for changes within groups <0.05; no inter-group comparison p value was reported). Mean scores for endoscopic evaluations of turbinate secretions decreased from 1.7 to 0.6 in the radiofrequency-assisted turbinoplasty group and from 1.7 to 0.5 in the traditional surgery group at 3‑month follow-up (p values for changes within groups were less than 0.05; no inter-group comparison p value was reported).

4.3

In the randomised controlled trial of 120 patients treated by radiofrequency or microdebrider-assisted turbinoplasty, mean total nasal resistance measurements (using 75 Pa as the reference point) improved from 0.31 to 0.15 Pa/ml/s (p<0.05) and from 0.32 to 0.15 Pa/ml/s (p<0.05) respectively at 6‑month follow-up (inter-group comparison p value not significant). At 3‑year follow-up, mean total nasal resistance measurements in the radiofrequency and microdebrider-assisted turbinoplasty groups were 0.31 and 0.16 Pa/ml/s respectively (p<0.05).

4.4

In a case series of 197 patients treated by radiofrequency-assisted turbinoplasty, mean volumes of the region extending from the nostril to 5 cm within the nasal cavity increased from 5.55 cm3 at baseline to 10.56 cm3 at 5‑year follow-up (p<0.05).

4.5

Specialist advisers listed key efficacy outcomes as subjective improvements of the nasal airway assessed by validated questionnaires such as the Sino-Nasal Outcome Test.