温控射频神经松解术治疗慢性鼻炎的长期疗效

IF 2.3 Q1 OTORHINOLARYNGOLOGY Allergy & Rhinology Pub Date : 2022-05-29 eCollection Date: 2022-01-01 DOI:10.1177/21526575221096045
Dale Ehmer, Chad M McDuffie, J Bradley McIntyre, Bryan M Davis, Neelesh H Mehendale, John H Willis, Jeremy P Watkins, V Vasu Kakarlapudi
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引用次数: 0

摘要

背景鼻后神经的温控射频神经松解术已被证明可以减轻慢性鼻炎患者的症状负担。目的评价鼻后神经温控射频松解术治疗慢性鼻炎的长期安全性和有效性。方法对一项为期12个月的单臂研究进行前瞻性扩展,在24个月时收集反映性总鼻症状评分(rTNSS)以及对研究特定生活质量问卷和患者满意度调查的回答。结果47例患者在使用该研究装置治疗后完成了12个月的初始随访,其中34例患者再次住院,完成了24个月的随访。长期随访患者的平均rTNSS从基线时的8.4(95%置信区间(CI),7.7~9.0)改善到2.9(95%可信区间,2.1~3.6),P < .001,改善65.5%。在6分制(0-5)中,从基线到24个月,鼻后滴注从平均4.1(95%置信区间,3.6至4.6)改善到2.1(95%可信区间,1.7至2.5),慢性咳嗽从3.2(95%可信范围,2.7至3.6)改善到0.9(95%可信范围,0.5至1.3);P < .001。在24个月时,与基线相比,获得30%改善的最小临床重要差异的患者比例为88.2%(95%CI,73.4%-95.3%)。在24个月中,24%的患者总体上比基线减少了鼻炎药物类别,15%的患者总体增加了鼻炎药物类别。患者报告称,在24个月时,他们在睡眠、健康和口服药物/鼻喷雾剂使用方面的生活质量更高。在12-24个月期间,没有发生与手术相关的严重不良事件。结论温控射频神经松解术可显著、持久地减轻慢性鼻炎的症状负担,术后24个月患者的生活质量得到改善。
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Long-term Outcomes Following Temperature-Controlled Radiofrequency Neurolysis for the Treatment of Chronic Rhinitis.

Background: Temperature-controlled radiofrequency neurolysis of the posterior nasal nerve has been shown to reduce the symptom burden of patients with chronic rhinitis.

Objectives: To evaluate the long-term safety and effectiveness of temperature-controlled radiofrequency neurolysis of the posterior nasal nerve for the treatment of chronic rhinitis.

Methods: A prospective extension of a 12-month single-arm study, where reflective total nasal symptom score (rTNSS) and the responses to a study-specific quality of life questionnaire and patient satisfaction survey were collected at 24 months.

Results: Forty-seven patients completed initial 12-month follow-up after treatment with the study device, of which 34 patients were reconsented and completed 24-month follow-up. The mean rTNSS of the long-term follow-up patients improved from 8.4 (95% confidence interval (CI), 7.7 to 9.0) at baseline to 2.9 (95% CI, 2.1 to 3.6), P < .001 at 24 months, a 65.5% improvement. On a 6-point scale (0-5), postnasal drip improved from a mean of 4.1 (95% CI, 3.6 to 4.6) to 2.1 (95% CI, 1.7 to 2.5) and chronic cough improved from 3.2 (95% CI, 2.7 to 3.6) to 0.9 (95% CI, 0.5 to 1.3) from baseline through 24 months; P < .001 for both measures. The proportion of patients achieving a minimal clinically important difference of 30% improvement from baseline at 24 months was 88.2% (95% CI, 73.4%-95.3%). At 24 months, 24% of patients were taking overall fewer and 15% taking overall more rhinitis medication classes than at baseline. Patients reported a higher quality of life in terms of sleep, well-being, and lower oral medication/nasal spray use at 24 months. There were no serious adverse events considered related to the procedure in the 12-24-month period.

Conclusion: Temperature-controlled radiofrequency neurolysis results in a significant and durable reduction in the symptom burden of chronic rhinitis and patients reported improved quality of life through 24 months postprocedure.

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来源期刊
Allergy & Rhinology
Allergy & Rhinology OTORHINOLARYNGOLOGY-
CiteScore
3.30
自引率
4.50%
发文量
11
审稿时长
15 weeks
期刊最新文献
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