Clinical Efficacy of Inferior Turbinate Outfracture Combined with Low-Temperature Plasma Radiofrequency Ablation in Obese Patients with Obstructive Sleep Apnea-Hypopnea Syndrome Complicated with Nasal Obstruction

Objective To evaluate the long-term clinical efficacy of combined inferior turbinate outfracture and low-temperature plasma radiofrequency ablation on nasal ventilation, continuous positive airway pressure tolerance, sleep status and body mass index (BMI) in obese patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) complicated with bilateral inferior turbinate hypertrophy, whose BMI ≥28.0 kg/m 2 . Methods This single-center retrospective study enrolled a total of 40 obese OSAHS patients with bilateral inferior turbinate hypertrophy treated at the Department of Otorhinolaryngology, Liangxiang Hospital from August 2023 to August 2024. All subjects received combined inferior turbinate outfracture and low-temperature plasma radiofrequency ablation under general anesthesia. Outcome indicators including nasal airway resistance, apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS), visual analogue scale (VAS) for nasal continuous positive airway pressure (nCPAP) tolerance and BMI were detected before surgery, 1 month, 6 months and 1 year postoperatively. Polysomnography, anterior rhinomanometry and standardized scale assessment were performed uniformly at each follow-up time point. Intra-group comparisons between preoperative and postoperative data were analyzed by paired t-test; P < 0.05 was defined as statistically significant. Results All 40 patients completed the 1-year standardized follow-up without loss to follow-up. Compared with preoperative baseline levels, nasal airway resistance, AHI, ESS scores and BMI were significantly decreased at 1, 6 and 12 months after surgery (all P < 0.05), while VAS scores reflecting nCPAP tolerance increased markedly (all P < 0.05). Nasal airway resistance remained stable at a low level within one year after operation. AHI and BMI were further reduced at postoperative 1 year compared with 1 month after surgery (P < 0.05), and ESS scores achieved the optimal improvement at postoperative 6 months. Conclusion Observations from this case series suggest that the combined inferior turbinate outfracture and low-temperature plasma radiofrequency ablation may represent a feasible minimally invasive surgical option for obese OSAHS patients with nasal obstruction, inferior turbinate hypertrophy and documented CPAP intolerance. Within this cohort, we observed postoperative reductions in nasal airway resistance, AHI, ESS scores and BMI, accompanied by improved self-reported nCPAP tolerance. However, we cannot quantify how much of these improvements stem from nasal surgery versus weight loss, CPAP use or other unmeasured factors. A reduction in BMI cannot be interpreted as evidence that surgery induces weight loss. The hypothesis of a positive therapeutic cycle remains speculative, as data regarding diet, exercise, weight-loss interventions and objective CPAP usage were not collected. No postoperative infection or active bleeding was observed in the present cohort; nevertheless, other potential complications were not systematically assessed, so the safety profile of this procedure cannot be fully determined. This surgical approach avoids the high perioperative risks of traditional extensive pharyngeal surgery and provides a potential observational reference for obese OSAHS patients with severe nasal stenosis.