Beckman Laser Institute and Medical Clinic, Irvine, California, USA.
Department of Otolaryngology - Head and Neck Surgery, University of California - Irvine Medical Center, Orange, California, USA.
Laryngoscope. 2024 Mar;134(3):1063-1070. doi: 10.1002/lary.30942. Epub 2023 Aug 18.
Nasal airway obstruction (NAO) is caused by various disorders including nasal valve collapse (NVC). A bipolar radiofrequency (RF) device (VivAer®, Aerin Medical, Sunnyvale, CA) has been used to treat NAO through RF heat generation to the upper lateral cartilage (ULC). The purpose of this study is to measure temperature elevations in nasal tissue, using infrared (IR) radiometry to map the spatial and temporal evolution of temperature.
Experimental and computational.
Composite porcine nasal septum was harvested and sectioned (1 mm and 2 mm). The device was used to heat the cartilage in composite porcine septum. An IR camera (FLIR® ExaminIR, Teledyne, Wilsonville, OR) was used to image temperature on the back surface of the specimen. These data were incorporated into a heat transfer finite element model that also calculated tissue damage using Arrhenius rate process.
IR temperature imaging showed peak back surface temperatures of 49.57°C and 42.21°C in 1 and 2 mm thick septums respectively. Temperature maps were generated demonstrating the temporal and spatial evolution of temperature. A finite element model generated temperature profiles with respect to time and depth. Rate process models using Arrhenius coefficients showed 30% chondrocyte death at 1 mm depth after 18 s of RF treatment.
The use of this device creates a thermal profile that may result in thermal injury to cartilage. Computational modeling suggests chondrocyte death extending as deep as 1.4 mm below the treatment surface. Further studies should be performed to improve dosimetry and optimize the heating process to reduce potential injury. Laryngoscope, 134:1063-1070, 2024.
鼻气道阻塞(NAO)是由多种疾病引起的,包括鼻阀塌陷(NVC)。双极射频(RF)设备(VivAer®,Aerin Medical,加利福尼亚州森尼韦尔)已被用于通过 RF 加热上外侧软骨(ULC)来治疗 NAO。本研究的目的是使用红外(IR)辐射测量法测量鼻组织中的温度升高,以绘制温度的空间和时间演变图。
实验和计算。
采集并切片复合猪鼻中隔(1mm 和 2mm)。使用该设备加热复合猪鼻中隔的软骨。使用红外摄像机(FLIR®ExaminIR,Teledyne,俄勒冈州威尔逊维尔)对标本背面的温度进行成像。这些数据被纳入传热有限元模型中,该模型还使用 Arrhenius 速率过程计算组织损伤。
IR 温度成像显示,在 1mm 和 2mm 厚的鼻中隔中,背面的峰值温度分别为 49.57°C 和 42.21°C。生成了温度图,显示了温度的时间和空间演变。有限元模型生成了随时间和深度变化的温度分布。使用 Arrhenius 系数的速率过程模型显示,在 18s 的 RF 治疗后,1mm 深度处有 30%的软骨细胞死亡。
该设备的使用会产生可能导致软骨热损伤的热分布。计算模型表明,软骨细胞死亡可延伸至治疗表面以下 1.4mm 深处。应进一步进行研究,以改善剂量学并优化加热过程,以减少潜在的损伤。喉镜,134:1063-1070,2024。