Pritikin Jordan, Silvers Stacey, Rosenbloom Jeffrey, Davis Bryan, Signore Anthony Del, Sedaghat Ahmad R, Tajudeen Bobby A, Schmale Isaac, Lyons Jack, Corey Jacquelynne, Chandra Rakesh
Chicago Nasal & Sinus Center, Chicago, Illinois, USA.
Madison ENT & Facial Plastic Surgery, New York, New York, USA.
Int Forum Allergy Rhinol. 2023 Oct;13(10):1915-1925. doi: 10.1002/alr.23156. Epub 2023 Mar 27.
Nasal airway obstruction (NAO) is a highly prevalent disorder. Septal swell body (SSB) hypertrophy is an often overlooked contributor to NAO. SSB treatment may relieve symptoms of NAO. The objective of this study was to assess the clinical use of a temperature-controlled radiofrequency (TCRF) device to treat SSBs to improve symptoms in adults with NAO.
In this prospective, multicenter, open-label, single arm study, patients with severe or extreme NAO related to SSB hypertrophy received bilateral TCRF treatment in the SSB area. The primary endpoint was improvement in Nasal Obstruction Symptom Evaluation (NOSE) Scale scores from baseline to 3 months postprocedure. A subset of study patients underwent computed tomography (CT) imaging to evaluate posttreatment changes in SSB size.
Mean NOSE Scale scores significantly improved from 73.5 (SD 14.2) at baseline to 27.9 (SD 17.2) at 3 months postprocedure, a reduction of -45.3 (SD 21.4, 95% confidence interval [CI]: -50.4 to -40.1; p < 0.0001); the responder rate was 95.7% (95% CI: 0.88 to 0.99; p < 0.0001). CT evaluation at 3 months showed statistically significant reductions in the SSB with the greatest reduction in the middle thickness (mean change -3.4 [SD 1.8] mL, 95% CI: -4.0 to -2.8; p < 0.0001). Minimal adverse events with any relationship to the device or procedure were reported; none were serious in nature and no septal perforations occurred.
This study demonstrates that TCRF treatment of SSB hypertrophy is well tolerated and effective at reducing both SSB size and symptoms of NAO at 3 months posttreatment.
鼻气道阻塞(NAO)是一种高度常见的疾病。鼻中隔肿胀体(SSB)肥大是NAO中一个常被忽视的病因。SSB治疗可能缓解NAO症状。本研究的目的是评估温控射频(TCRF)设备治疗SSB以改善成年NAO患者症状的临床应用。
在这项前瞻性、多中心、开放标签、单臂研究中,与SSB肥大相关的重度或极重度NAO患者在SSB区域接受双侧TCRF治疗。主要终点是从基线到术后3个月鼻塞症状评估(NOSE)量表评分的改善情况。一部分研究患者接受了计算机断层扫描(CT)成像,以评估治疗后SSB大小的变化。
NOSE量表平均评分从基线时的73.5(标准差14.2)显著改善至术后3个月时的27.9(标准差17.2),降低了-45.3(标准差21.4,95%置信区间[CI]:-50.4至-40.1;p<0.0001);缓解率为95.7%(95%CI:0.88至0.99;p<0.0001)。3个月时的CT评估显示SSB有统计学意义的缩小,其中中间厚度缩小最大(平均变化-3.4[标准差1.8]mL,95%CI:-4.0至-2.8;p<0.0001)。报告的与设备或操作有任何关联的不良事件极少;均不严重,且未发生鼻中隔穿孔。
本研究表明,TCRF治疗SSB肥大耐受性良好,且在治疗后3个月能有效缩小SSB大小并减轻NAO症状。