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鼻后神经ClariFix(冷冻消融)治疗慢性鼻炎患者鼻部症状的有效性:一项系统评价和荟萃分析

Effectiveness of ClariFix (Cryoablation) of the Posterior Nasal Nerve on Nasal Symptoms in Patients With Chronic Rhinitis: A Systematic Review and Meta-Analysis.

作者信息

Choi Bo Yun, Hwang Se Hwan, Kim Do Hyun

机构信息

Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Department of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

出版信息

J Rhinol. 2024 Jul;31(2):57-66. doi: 10.18787/jr.2024.00015. Epub 2024 Jul 31.

Abstract

BACKGROUND AND OBJECTIVES

The present study evaluated the efficacy of cryoablation of the posterior nasal nerve in alleviating symptoms associated with chronic rhinitis.

METHODS

A systematic review of pertinent literature sourced from PubMed, Scopus, Embase, Web of Science, and Cochrane databases was conducted through May 2024. The analysis focused on studies that appraised changes in quality of life and rhinitis-associated symptomatology before and after cryoablation treatment.

RESULTS

A total of seven studies (495 patients) were included in the analysis. Significant improvements in rhinitis-related symptoms were observed in patients undergoing cryoablation, irrespective of etiology (allergic or nonallergic rhinitis). Furthermore, cryoablation yielded improvements in disease-specific quality of life, as measured by the Rhinoconjunctivitis Quality of Life Questionnaire. Notably, a clinically significant reduction (≥30% decrease from baseline) in total nasal symptomatology was noted in 71% of cases following cryoablation. Regarding the incidence of adverse effects, nasal dryness, epistaxis, ocular symptoms, and palatal numbness occurred in <5% of patients, while postoperative pain occurred in 10% and headache in 20% of patients who underwent treatment. In subtype analysis, the total nasal symptom score in nonallergic rhinitis showed a significantly increasing pattern over time (p=0.0017).

CONCLUSION

Cryoablation of the posterior nasal nerve appears to yield a decrease in subjective nasal symptom scores and an improvement in disease-specific quality of life. Notably, these effects persisted for up to 12 months post-treatment, with marked improvements observed in both allergic and nonallergic rhinitis subtypes.

摘要

背景与目的

本研究评估了鼻后神经冷冻消融术在缓解慢性鼻炎相关症状方面的疗效。

方法

对截至2024年5月从PubMed、Scopus、Embase、科学网和Cochrane数据库中获取的相关文献进行系统综述。分析重点关注评估冷冻消融治疗前后生活质量变化以及鼻炎相关症状的研究。

结果

分析共纳入7项研究(495例患者)。接受冷冻消融术的患者,无论病因(过敏性或非过敏性鼻炎)如何,鼻炎相关症状均有显著改善。此外,通过鼻结膜炎生活质量问卷测量,冷冻消融术使疾病特异性生活质量得到改善。值得注意的是,71%的病例在冷冻消融术后总鼻部症状出现具有临床意义的降低(较基线水平降低≥30%)。关于不良反应的发生率,鼻干、鼻出血、眼部症状和腭部麻木在<5%的患者中出现,而术后疼痛在接受治疗的患者中发生率为10%,头痛发生率为20%。在亚组分析中,非过敏性鼻炎的总鼻部症状评分随时间呈显著上升趋势(p=0.0017)。

结论

鼻后神经冷冻消融术似乎可降低主观鼻部症状评分,并改善疾病特异性生活质量。值得注意的是,这些效果在治疗后可持续长达12个月,在过敏性和非过敏性鼻炎亚型中均观察到显著改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fee5/11566528/af20b96bb89c/jr-2024-00015f1.jpg

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