Radiofrequency Volumetric Reduction (RAVOR) as A Treatment for Inferior Turbinates Hypertrophy

In this video we can see the use of a radiofrequency device, one of the techniques which is used for the management of persistent and symptomatic nasal blockage, caused by inferior turbinates hypertrophy. The main aim of the intraoperative endoscopy was to assess the overall configuration and to look out the more hidden parts posteriorly. It is ideal to decongest preliminary nose with cocaine packing or alternatively by using Moffat's solution. Marcain and adrenaline or saline are infiltrated by the inferior turbinates to give back the bulk prior to probe insertion as well as for the anaesthetic effect. The double-tip probe then fully embedded until it reached the insulated marking (black in colour). Having it confirmed, the tip does not extrude at the other end, then the radiofrequency energy is delivered with the press of the foot pedal. The sound will be produced by the machine which will stop as the energy needed is fully delivered. In the majority, we can observe immediately a visible shrinking of the turbinate tissue. A few application sites need to be done on either sides, depending on the degree and extent of hypertrophy. The probe is slightly retracted after completion and another energy delivered for about 2 seconds at the entrance point of the probe, for a better homeostasis. A reactive oedema, which will be worsening a condition of nasal obstruction, will occur after a few days and will become better after a week post-procedure. Some blood stains and a nasal discharge is common, and if the dual probe was located too superficial, crusting can develop. To enhance clearance of formed scabs/dried secretions in the nasal cavity, a regular nasal douching is helpful. We can perform this procedure in two ways or under a local anaesthesia as an office procedure or alternatively under a general anaesthesia. [Disclaimer: Radiofrequency device and its accessories used in this video are from Sutter. The recorded video is intended for educational purpose only].