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Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue volume reduction); intramural (ie, submucosal)

CPT4 code

Name of the Procedure:

Ablation of the Soft Tissue of Inferior Turbinates, Unilateral or Bilateral. Also known as:

  • Turbinate ablation
  • Inferior turbinate reduction
  • Submucosal turbinate reduction
  • Electrocautery of turbinates
  • Radiofrequency turbinate reduction (RFTR)

Summary

Turbinate ablation is a medical procedure used to reduce the size of the inferior turbinates, which are structures inside the nose. This can be done through various methods, including electrocautery, radiofrequency ablation, or tissue volume reduction. The goal is to improve airflow through the nose and alleviate nasal congestion.

Purpose

This procedure addresses conditions such as chronic nasal congestion, nasal obstruction, and breathing difficulties caused by enlarged inferior turbinates. The expected outcomes include improved nasal airflow and reduced symptoms of nasal obstruction.

Indications

  • Chronic nasal congestion not responsive to medication
  • Nasal obstruction impacting daily activities or sleep
  • Difficulty breathing through the nose
  • Recurring sinus infections due to nasal blockage

Preparation

  • Follow the healthcare provider's instructions about fasting and medication adjustments prior to the procedure.
  • Pre-procedure diagnostic tests may include nasal endoscopy or imaging studies to assess the turbinates.
  • Stop smoking, as it can affect healing and recovery.

Procedure Description

  1. The patient is prepared and positioned in a reclining chair or operating table.
  2. Local anesthesia is applied to numb the inside of the nose.
  3. The physician inserts an instrument into the nasal passage to access the inferior turbinates.
  4. Using a method such as electrocautery, radiofrequency ablation, or tissue volume reduction, the physician ablates the soft tissue within the turbinate, reducing its size submucosally.
  5. The procedure is either unilateral (one side) or bilateral (both sides), depending on the patient's condition.

Duration

The procedure typically takes about 20 to 45 minutes.

Setting

The procedure is performed in an outpatient clinic, surgical center, or hospital.

Personnel

  • Otorhinolaryngologist (ENT Surgeon)
  • Nurses
  • Anesthesiologist (if sedation or general anesthesia is used)

Risks and Complications

  • Bleeding
  • Infection
  • Crusting inside the nose
  • Scar tissue formation
  • Recurrence of nasal obstruction
  • Change in sense of smell (rare)

Benefits

  • Improved nasal breathing
  • Reduction in nasal congestion
  • Enhanced quality of life and sleep
  • Decrease in the frequency of sinus infections

Recovery

  • Post-procedure care includes nasal saline sprays to keep the nasal passages moist.
  • Avoid strenuous activity and nose blowing for a few days.
  • Follow-up appointments are typically scheduled to monitor healing.
  • Full recovery can be expected within 1 to 2 weeks, although nasal symptoms might improve sooner.

Alternatives

  • Medical therapy (e.g., nasal steroid sprays, antihistamines)
  • Septoplasty (if structural deformity contributes to obstruction)
  • Turbinate outfracture (less invasive, physical repositioning of turbinates)
  • Each alternative has its own set of benefits and limitations compared to turbinate ablation.

Patient Experience

  • Patients might experience mild discomfort or a feeling of nasal congestion immediately after the procedure.
  • Pain is usually minimal and can be managed with over-the-counter pain relievers.
  • Mild bleeding or crusting may occur but usually resolves with proper post-procedure care.
  • Most patients report significant improvement in nasal breathing once healing is complete.

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