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鼻腔气道阻塞患者使用温控射频设备治疗鼻瓣膜的两年疗效

Two-year outcomes of temperature-controlled radiofrequency device treatment of the nasal valve for patients with nasal airway obstruction.

作者信息

Yao William C, Pritikin Jordan, Sillers Michael J, Barham Henry P

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery McGovern Medical School at the University of Texas Health Science Center Houston Texas USA.

Chicago Nasal and Sinus Center Chicago Illinois USA.

出版信息

Laryngoscope Investig Otolaryngol. 2023 Jun 15;8(4):808-815. doi: 10.1002/lio2.1089. eCollection 2023 Aug.

Abstract

BACKGROUND

The objective of this study was to evaluate long-term symptom improvements in patients with nasal airway obstruction (NAO) secondary to nasal valve collapse (NVC) following minimally invasive temperature-controlled radiofrequency (TCRF) treatment.

METHODS

A prospective, single-arm, multicenter study in patients >18 years with NAO due to NVC. Inclusion criteria were response to nasal valve dilation (e.g., modified Cottle maneuver) and baseline Nasal Obstruction Symptom Evaluation (NOSE) Scale score ≥60. Patients were treated in the nasal valve region with a TCRF device and followed through 2 years. A responder was ≥20% reduction NOSE Scale score or ≥1 reduction in severity class.

RESULTS

A total of 122 patients were treated and 91 reached 2 years. The mean baseline NOSE Scale score was 80.3 (95% CI, 78.1-82.6). The adjusted mean change in score at 2 years was -45.8 (95% CI, -53.5 to -38.1),  < 0.001; a 57.0% improvement. The 2-year responder rate was 90.1% (95% CI, 82.3%-94.7%). Significant and sustained symptom improvement was achieved in subpopulations based on sex, age, body mass index, baseline NAO severity, nasal surgery history, NVC mechanism, septal deviation, and other anatomic contributors of NAO. No serious adverse events with a relationship to the study device and/or procedure were reported.

CONCLUSIONS

Minimally invasive TCRF device treatment of the internal nasal valve for NAO is well tolerated and leads to significant and sustained improvement in NAO symptom severity through 2 years, including in patients with both static and dynamic NVC, septal deviation, turbinate enlargement, or prior nasal surgery.

LEVEL OF EVIDENCE

2b.

摘要

背景

本研究的目的是评估微创温控射频(TCRF)治疗后,因鼻瓣膜塌陷(NVC)继发鼻气道阻塞(NAO)的患者长期症状改善情况。

方法

一项针对年龄大于18岁、因NVC导致NAO的患者的前瞻性、单臂、多中心研究。纳入标准为对鼻瓣膜扩张(如改良科特尔手法)有反应,且基线鼻阻塞症状评估(NOSE)量表评分≥60。患者在鼻瓣膜区域接受TCRF设备治疗,并随访2年。反应者定义为NOSE量表评分降低≥20%或严重程度等级降低≥1级。

结果

共治疗122例患者,91例达到2年随访。平均基线NOSE量表评分为80.3(95%CI,78.1-82.6)。2年时调整后的平均评分变化为-45.8(95%CI,-53.5至-38.1),P<0.001;改善率为57.0%。2年反应率为90.1%(95%CI,82.3%-94.7%)。基于性别、年龄、体重指数、基线NAO严重程度、鼻部手术史、NVC机制、鼻中隔偏曲以及NAO的其他解剖学因素的亚组均实现了显著且持续的症状改善。未报告与研究设备和/或操作相关的严重不良事件。

结论

微创TCRF设备治疗NAO的鼻内瓣膜耐受性良好,并在2年内使NAO症状严重程度得到显著且持续的改善,包括静态和动态NVC、鼻中隔偏曲、鼻甲肥大或既往鼻部手术患者。

证据水平

2b。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d735/10446315/30d6aa7bc52c/LIO2-8-808-g006.jpg

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