Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio, U.S.A.
Laryngoscope. 2021 Jun;131(6):E1760-E1769. doi: 10.1002/lary.29223. Epub 2020 Nov 3.
OBJECTIVES/HYPOTHESIS: Low energy radiofrequency may offer effective treatment for narrow or obstructed nasal valve, yet its precise mechanism is not fully understood.
Prospective, nonrandomized, case series.
Twenty prospective patients with internal nasal valve obstruction underwent office-based Vivaer treatment (Aerin Medical, Inc) under local anesthesia. Computational fluid dynamics (CFD) models were constructed based on the pre- and 90 days post-procedure computed tomography (CT) scans to identify salient changes in nasal airflow parameters.
Patients' Nasal Obstruction Symptom Evaluation score (NOSE: pre-treatment 78.89 ± 11.57; post-treatment 31.39 ± 18.30, P = 5e-7) and Visual Analog Scale of nasal obstruction (VAS: pre-treatment 6.01 ± 1.83; post-treatment 3.44 ± 2.11, P = 1e-4) improved significantly at 90 days after the minimally invasive approach. Nasal airway volume in the treatment area increased ~7% 90 days post-treatment (pre-treatment 5.97 ± 1.20, post-treatment 6.38 ± 1.50 cm , P = .018), yet there were no statistically significant changes in the measured peak nasal inspiratory flowrate (PNIF, pre-treatment: 60.16 ± 34.49; post-treatment: 72.38 ± 43.66 ml/s; P = .13) and CFD computed nasal resistance (pre-treatment: 0.096 ± 0.065; post-treatment: 0.075 ± 0.026 Pa/(ml/s); P = .063). As validation, PNIF correlated significantly with nasal resistance (r = 0.47, P = .004). Among all the variables, only the peak mucosal cooling posterior to the nasal vestibule significantly correlated with the NOSE at baseline (r = -0.531, P = .023) and with post-treatment improvement (r = 0.659, P = .003).
Minimal remodeling of the nasal valve (7% in this study) may have a profound effect on perceived nasal obstruction, despite little effect on nasal resistance, or PNIF. The results corroborated our previous findings that subjective relief of nasal obstruction correlates with regional mucosal cooling rather than nasal resistance or peak flow rate, a potential target for future effective, personalized therapeutic approaches.
4 Laryngoscope, 131:E1760-E1769, 2021.
目的/假设：低能量射频可能为狭窄或阻塞的鼻阀提供有效治疗，但确切机制尚不完全清楚。
前瞻性、非随机、病例系列。
20 例内部鼻阀阻塞患者在局部麻醉下接受 Vivaer 治疗（Aerin Medical，Inc）。基于术前和术后 90 天的计算机断层扫描（CT）扫描构建计算流体动力学（CFD）模型，以确定鼻气流参数的明显变化。
患者的鼻阻塞症状评估评分（NOSE：治疗前 78.89±11.57；治疗后 31.39±18.30，P=5e-7）和鼻阻塞视觉模拟评分（VAS：治疗前 6.01±1.83；治疗后 3.44±2.11，P=1e-4）在微创治疗后 90 天显著改善。治疗区域的鼻腔气道容积在治疗后 90 天增加了约 7%（治疗前 5.97±1.20，治疗后 6.38±1.50cm3，P=0.018），但测量的最大鼻吸气流量（PNIF，治疗前：60.16±34.49；治疗后：72.38±43.66ml/s；P=0.13）和 CFD 计算的鼻腔阻力（治疗前：0.096±0.065；治疗后：0.075±0.026Pa/（ml/s）；P=0.063）均无统计学显著变化。作为验证，PNIF 与鼻腔阻力显著相关（r=0.47，P=0.004）。在所有变量中，只有鼻前庭后的最大粘膜冷却与 NOSE 在基线时（r=-0.531，P=0.023）和治疗后改善时（r=0.659，P=0.003）显著相关。
尽管对鼻腔阻力或 PNIF 影响很小，但鼻阀的最小重塑（在这项研究中为 7%）可能对感知的鼻腔阻塞产生深远影响。结果证实了我们之前的发现，即鼻腔阻塞的主观缓解与局部粘膜冷却相关，而与鼻腔阻力或最大流量相关，这可能是未来有效、个性化治疗方法的潜在靶点。
4.喉镜，131：E1760-E1769，2021。
Zotero 插件