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March 2009 Issue

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Simple Procedure Can Improve Breathing

Published March 2009

If you’re experiencing chronic breathing difficulties, a simple procedure with a complicated name could be the answer to your problem.

Radiofrequency ablation of the turbinates—put more simply, reducing the size of tissue within the nose with the aid of a needleequipped heating device—is a procedure that can be done in a physician’s office under local anesthesia.

That gives it a big advantage over traditional surgery, which involves removing part of the turbinates under general anesthesia in an operating room, says Lee Zimmer, MD, an assistant professor of otolaryngology.

“It’s quicker, safer, convenient and painless,” says Zimmer, adding that the procedure itself only takes about 12 minutes after the local anesthetic takes effect.

Turbinates are structures located inside the nose—three on each side—covered with mucus membranes. They warm and moisten air that is breathed in and also trap allergens, bacteria and viruses, keeping them from gaining access to the body. Enlarged turbinates hinder air intake, so the goal of radiofrequency ablation is to shrink them so the patient gains more volume for breathing.

“Every time you increase the radius of space in the nose you’re increasing airflow to the power of four,” Zimmer says. “So you don’t need a lot.” Inserting a needle into three points on each of the two inferior (lowest) turbinates, Zimmer heats the tissue to approximately 70 degrees Celsius (158 degrees Fahrenheit).

That breaks down protein, shrinking the size of the turbinate, and causes an inflammatory reaction—scarring—which also serves to shrink the turbinate.

During the first few days of recovery, Zimmer recommends saltwater sprays and a decongestant spray for two or three days, plus over-the-counter Tylenol as needed for discomfort. It takes about four weeks to get 80 percent healing from the scarring,

Zimmer says, and the typical patient feels a difference in breathing by that time. Likely candidates for the procedure are patients who complain of nasal congestion—not sinusitis (inflammation of the sinuses)— who have been treated with prescription medications without success. Because of the electrical current involved, the procedure is not performed on patients who use pacemakers.

For an appointment with a UC otolaryngologist, call (513) 475- 8400.

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