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评估隆鼻术后鼻塞的治疗效果:VivAer 射频消融术的疗效。

Evaluating post-rhinoplasty nasal obstruction treatment: The efficacy of VivAer radiofrequency ablation.

机构信息

Division of Otolaryngology, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America.

Division of Otolaryngology, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America.

出版信息

Am J Otolaryngol. 2024 Jul-Aug;45(4):104338. doi: 10.1016/j.amjoto.2024.104338. Epub 2024 Apr 26.

Abstract

PURPOSE

Nasal obstruction is a prevalent issue affecting up to one-third of adults, often requiring surgical intervention. Low-temperature radiofrequency (RF) treatment, specifically VivAer, has emerged as a promising alternative, especially for the treatment of nasal valve collapse (NVC). However, its efficacy in patients with a history of rhinoplasty or nasal valve repair remains unexplored.

METHODS

A single-center retrospective chart review was conducted on 37 patients with a history of rhinoplasty or nasal valve repair who underwent VivAer RF treatment. Treatment outcomes were assessed using the Nasal Obstruction Symptom Evaluation (NOSE) scale. The primary outcome was defined as a decrease in NOSE score by at least one severity category or a 20 % reduction in total NOSE score.

RESULTS

The study found a statistically significant average reduction in NOSE score of 22.4 points or 36.6 %. Among patients with a positive treatment response (21 patients or 56.8 %), the average NOSE score reduction was 34.7 points or 55.6 %. Repeat RF treatment in non-responders resulted in a 50 % response rate. No significant difference was observed in treatment outcomes based on the type of prior rhinoplasty or NVC.

CONCLUSIONS

Temperature-controlled RF treatment with VivAer can effectively alleviate nasal obstruction in patients with a history of rhinoplasty or nasal valve repair, offering a viable alternative to revision surgery. The study also highlights the potential benefit of repeat RF treatment in non-responders. Further research, including randomized controlled trials, is needed to validate these promising results and expand the treatment options for this complex patient population.

摘要

目的

鼻塞是一种常见的问题,影响多达三分之一的成年人,通常需要手术干预。低温射频(RF)治疗,特别是 VivAer,已成为一种有前途的替代方法,特别是对于治疗鼻阀塌陷(NVC)。然而,其在有鼻整形术或鼻阀修复史的患者中的疗效尚未得到探索。

方法

对 37 例有鼻整形术或鼻阀修复史的患者进行了单中心回顾性图表审查,这些患者接受了 VivAer RF 治疗。使用鼻阻塞症状评估(NOSE)量表评估治疗结果。主要结果定义为 NOSE 评分至少降低一个严重程度类别或总 NOSE 评分降低 20%。

结果

研究发现,NOSE 评分的平均降低具有统计学意义,为 22.4 分或 36.6%。在有治疗反应的患者中(21 例或 56.8%),平均 NOSE 评分降低为 34.7 分或 55.6%。对无反应者进行重复 RF 治疗可使反应率达到 50%。根据先前鼻整形术或 NVC 的类型,治疗结果没有观察到显著差异。

结论

VivAer 的温度控制 RF 治疗可以有效缓解有鼻整形术或鼻阀修复史的患者的鼻塞,为修正手术提供了一种可行的替代方法。该研究还强调了在无反应者中重复 RF 治疗的潜在益处。需要进一步的研究,包括随机对照试验,以验证这些有前途的结果,并为这一复杂患者群体扩大治疗选择。

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