Rhinologic Applications of Radiofrequency Coblation
Rhinologists from the Texas Sinus Institute of the Department of Otorhinolaryngology—Head and Neck Surgery at The University of Texas Medical School at Houston presented a study on the use of ArthroCare ENT Coblation® technology at the American Rhinologic Society spring meeting during the Combined Otolaryngology Spring Meetings (COSM) held April 28 – May 10, 2010, in Las Vegas. The study is a retrospective review of rhinologic procedures performed to manage sinonasal pathology over two and a half years. Coblation applies radiofrequency energy through a conductive medium of water and salt to create a plasma discharge that causes molecular dissociation and tissue disintegration on contact. The technology has attracted the interest of rhinologic surgeons because of its relatively low temperature (40° to 70° C) and hemostatic action.
Indications for Coblation include:
- Chronic rhinosinusitis with nasal polyps (20 patients)
- Benign neoplasm (7 patients)
- Encephalocele (4 patients)
- Malignant neoplasm (4 patients)
- Hereditary hemorrhagic telangiectasia (2 patients)
The PROciseXP and PROciseEZ wands were used. Because Coblation has a unique interaction with tissue, standard techniques were modified for optimal use of this technology. In each case, surgeons noted that Coblation achieved its surgical objective, permitting precise resection of the lesion and providing adequate hemostasis with improved endoscopic visualization.
“We’ve seen many recent advances in technology and techniques for endoscopic sinus surgery, but two challenges remain: how to remove pathology with minimal damage to surrounding tissues and how to minimize bleeding,” says Dr. Samer Fakhri, who is an associate professor at the UT Medical School. “In our practice we’ve used Coblation to treat various sinonasal pathologies, including four patients with meningoencephaloceles, where brain tissue that had herniated through the skull base into the sinuses. Coblation is quick with little blood loss, and by using a much lower temperature than cautery it minimizes damage to surrounding tissue. In conjunction with endoscopic surgery in the nose and skull base we’ve found it to be a useful technology in certain patients.”
Representative video clips have been posted.