Microdebrider-assisted turbinoplasty versus radiofrequency ablation for inferior turbinate hypertrophy: a systematic review and meta-analysis of randomized controlled trials

Abstract Purpose Inferior turbinate hypertrophy (ITH) is a common cause of chronic nasal obstruction, often requiring surgical intervention when medical treatments fail. Microdebrider-assisted turbinoplasty (MAT) and radiofrequency ablation (RA) are widely used techniques, but their comparative efficacy remains unclear. This study evaluates their perioperative and postoperative outcomes. Methods We searched PubMed, Cochrane Library, Scopus, and Embase up to May 31, 2025, for randomized controlled trials (RCTs) comparing MAT and RA in patients with ITH, following PRISMA 2020 guidelines. Outcomes included postoperative bleeding, nasal obstruction, nasal discharge, headache, and sneezing. Risk of bias was assessed using the Cochrane RoB 2 tool. Data were synthesized using risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI). Results Fifteen RCTs with 789 patients were included. RA significantly reduced postoperative bleeding risk compared to MAT (RR 3.84, 95% CI 1.74–8.49). Nasal obstruction showed no significant differences across time points, though MAT trended toward better long-term improvement (e.g., 1-year MD -1.47, 95% CI -5.15 to 2.21). Nasal discharge, headache, and sneezing outcomes were similar between groups. Additional outcomes like crusting and snoring were descriptively reported due to limited data. Conclusion Both MAT and RA effectively treat ITH, with RA minimizing postoperative bleeding and MAT offering potential long-term airflow benefits. Treatment choice should reflect patient-specific needs. Future studies should standardize outcomes and explore multimodal approaches.