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鼻内冷冻消融后鼻神经治疗鼻炎的评估

Evaluation of In-Office Cryoablation of Posterior Nasal Nerves for the Treatment of Rhinitis.

作者信息

Gerka Stuyt John A, Luk Lauren, Keschner David, Garg Rohit

机构信息

Department of Otolaryngology Head and Neck Surgery, Kaiser Permanente, Orange County, California.

出版信息

Allergy Rhinol (Providence). 2021 Jan 29;12:2152656720988565. doi: 10.1177/2152656720988565. eCollection 2021 Jan-Dec.

Abstract

BACKGROUND

Chronic rhinitis is a common condition generally treated with medical therapies. However, 10-22% of patients are refractory to medical therapies. A cryotherapy handheld device targeting the postganglionic nerve fibers of the posterior nasal nerve (PNN) now serves as an additional option for therapy. This study evaluates the efficacy of the cryosurgical ablation device of the PNN in the clinic setting.

METHODS

This was a prospective single-arm trial of 24 adult patients at seven locations within a large health maintenance organization. Patients with chronic rhinitis that failed medical therapy were offered an in-office cryoablation of PNN. Patients completed the Total Nasal Symptom Score (TNSS) questionnaire consisting of 5 items reported based on the previous 12 hours and 2 weeks at the following time points: pre-treatment, 30 days, 90 days and 1 year post-treatment.

RESULTS

Following cryoablation of the PNN, the TNSS 12-hour symptom score improved from 6.92 (±2.9) to 3.17 (±2.4, P < 0.001) at 30 days, 2.92 (±1.4, P < 0.001) at 90 days and 3.08 (±2.6, P < 0.001) at 1 year post treatment. Similar results were noted for the 2 weeks scores improving from 7.75 (±3.1) to 3.79 (±2.1, P < 0.001) at 30 days, 3.88 (±1.9, P < 0.001) at 90 days and 3.76 (±2.1, P < 0.001) at 1 year post-treatment. 64.7% of respondents stated the procedure decreased or eliminated nasal sprays.

CONCLUSIONS

Our independent evaluation of cryoablation of the PNN shows improvement in nasal symptoms over a 1 year period and is consistent with other published data.

摘要

背景

慢性鼻炎是一种常见疾病,通常采用药物治疗。然而,10%-22%的患者对药物治疗无效。一种针对鼻后神经(PNN)节后神经纤维的冷冻治疗手持设备现在成为了一种额外的治疗选择。本研究评估了PNN冷冻手术消融设备在临床环境中的疗效。

方法

这是一项在大型健康维护组织内七个地点对24名成年患者进行的前瞻性单臂试验。对药物治疗无效的慢性鼻炎患者提供门诊PNN冷冻消融治疗。患者在以下时间点完成由5项组成的总鼻症状评分(TNSS)问卷,这些症状基于前12小时和2周进行报告:治疗前、治疗后30天、90天和1年。

结果

PNN冷冻消融后,12小时症状评分在治疗后30天从6.92(±2.9)改善至3.17(±2.4,P<0.001),90天为2.92(±1.4,P<0.001),1年为3.08(±2.6,P<0.001)。2周评分也有类似结果,治疗后30天从7.75(±3.1)改善至3.79(±2.1,P<0.001),90天为3.88(±1.9,P<0.001),1年为3.76(±2.1,P<0.001)。64.7%的受访者表示该手术减少或停用了鼻喷雾剂。

结论

我们对PNN冷冻消融的独立评估显示,在1年时间内鼻症状有所改善,且与其他已发表数据一致。

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