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使用可吸收植入物(Latera)治疗鼻塞患者鼻中隔塌陷的疗效:系统评价和荟萃分析。

Effectiveness of using a bioabsorbable implant (Latera) to treat nasal valve collapse in patients with nasal obstruction: systemic review and meta-analysis.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Department of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

Int Forum Allergy Rhinol. 2020 Jun;10(6):719-725. doi: 10.1002/alr.22543. Epub 2020 Apr 13.

Abstract

BACKGROUND

Nasal obstruction is a common cause of breathing problems with lateral wall insufficiency (LWI) a key anatomic contributor. Recently, a bioabsorbable nasal implant was introduced to correct LWI and treat nasal obstruction. The goal of this study was to perform a systematic review with meta-analysis to determine the efficacy of the bioabsorbable nasal implant for treating nasal obstruction caused by LWI.

METHODS

Five databases (PubMed, SCOPUS, EMBASE, Web of Science, and the Cochrane Database) were independently reviewed by 2 researchers, starting at the earliest time point recorded in the database to September 2019. Studies that scored endoscopic lateral wall movement and nasal obstruction related to quality of life (QOL) postoperatively before and after bioabsorbable nasal implants and those that compared the outcomes of nasal implants (treatment group) with outcomes of sham surgery (control group) were included in the analysis.

RESULTS

Five studies (396 patients) met the inclusion criteria. Bioabsorbable nasal implants significantly reduced endoscopic lateral wall motion compared to pretreatment values and also improved QOL at 12 months postoperatively. Most adverse effects following the nasal implant, such as skin or mucosal reaction, infection, or implant retrieval, were reported with a 5% incidence rate. All adverse outcomes were resolved without significant sequelae. Compared with sham surgery, bioabsorbable nasal implants significantly improved disease-specific QOL.

CONCLUSION

Bioabsorbable nasal implants may reduce nasal wall movement and subjective symptom scores compared to preoperative status. More randomized clinical trials must be conducted to further verify the effectiveness of bioabsorbable nasal implants.

摘要

背景

鼻腔阻塞是侧壁不足(LWI)的常见原因,也是主要的解剖学因素。最近,一种可吸收的鼻腔植入物被引入以纠正 LWI 并治疗鼻腔阻塞。本研究的目的是进行系统评价和荟萃分析,以确定可吸收性鼻腔植入物治疗由 LWI 引起的鼻腔阻塞的疗效。

方法

两名研究人员独立检索了 5 个数据库(PubMed、SCOPUS、EMBASE、Web of Science 和 Cochrane 数据库),检索时间从数据库中最早记录的时间点开始到 2019 年 9 月。纳入的研究对术后可吸收性鼻腔植入物前后内镜下侧壁运动和与生活质量(QOL)相关的鼻腔阻塞进行评分,并将鼻腔植入物的结果(治疗组)与假手术(对照组)的结果进行比较。

结果

有 5 项研究(396 例患者)符合纳入标准。与术前相比,可吸收性鼻腔植入物可显著减少内镜下侧壁运动,并可改善术后 12 个月的 QOL。大多数鼻腔植入后的不良反应,如皮肤或黏膜反应、感染或植入物取出,其发生率为 5%。所有不良后果均得到解决,无明显后遗症。与假手术相比,可吸收性鼻腔植入物可显著提高疾病特异性 QOL。

结论

与术前状态相比,可吸收性鼻腔植入物可减少鼻腔壁运动和主观症状评分。需要更多的随机临床试验来进一步验证可吸收性鼻腔植入物的有效性。

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