Yosef P Krespi1, Karen A Wilson2, Victor Kizhner3. 1. Lenox Hill Hospital Northwell Health, 100 E 77th St, New York, NY 10075. Electronic address: Ykrespi1@northwell.edu. 2. Lenox Hill Hospital Northwell Health, 100 E 77th St, New York, NY 10075. 3. Mount Sinai St. Luke's, 1111 Amsterdam Ave, New York, NY 10025.
Abstract
BACKGROUND: Posterior nasal nerve (PNN) surgery, Radiofrequency (RF), and cryoablation have been described as alternative treatments for allergic and vasomotor rhinitis. We hypothesize that endoscopic (diode) laser ablation (ELA) is effective and less invasive than previously described methods. METHODS: An IRB approved prospective study was performed. Thirty-two patients with chronic rhinitis and nasal congestion resistant to medical management were recruited. Total Nasal Symptom Score (TNSS) measurements were used to assess symptom severity and treatment outcomes. ELA was performed bilaterally in the clinic with a 940 nm diode laser with CW 5 W output, under topical/local anesthesia in 21 patients, while the remaining 11 were treated under sedation in the operating room. The 400-micron uninitiated diode laser fiber tip with a malleable protective shaft was specially designed for PNN ablation. The fiber was pre-shaped according to the intranasal anatomy and endoscopically advanced toward the posterior middle meatus. Patients were followed up for the first 90 days after treatment. RESULTS: ELA was successfully completed in 97% of patients. No crusting, epistaxis, or other complications were observed. One patient could not be treated in the office due to limited endoscopic access. TNSS was reduced significantly after30 and 90 days (mean ± SD: 6.0 ± 0.7 prior to ablation, 2.3 ± 0.4 at 90 days, p < .001). Rhinitis and congestion scores decreased at 30 and 90 days after treatment compared to the baseline (p < .001). CONCLUSION: ELA of the PNN region is safe and well tolerated both in the office and ambulatory settings. Symptom scores were significantly decreased after 30 and 90 days. This new minimally invasive method appears to be a promising treatment method.
BACKGROUND:Posterior nasal nerve (PNN) surgery, Radiofrequency (RF), and cryoablation have been described as alternative treatments for allergic and vasomotor rhinitis. We hypothesize that endoscopic (diode) laser ablation (ELA) is effective and less invasive than previously described methods. METHODS: An IRB approved prospective study was performed. Thirty-two patients with chronic rhinitis and nasal congestion resistant to medical management were recruited. Total Nasal Symptom Score (TNSS) measurements were used to assess symptom severity and treatment outcomes. ELA was performed bilaterally in the clinic with a 940 nm diode laser with CW 5 W output, under topical/local anesthesia in 21 patients, while the remaining 11 were treated under sedation in the operating room. The 400-micron uninitiated diode laser fiber tip with a malleable protective shaft was specially designed for PNN ablation. The fiber was pre-shaped according to the intranasal anatomy and endoscopically advanced toward the posterior middle meatus. Patients were followed up for the first 90 days after treatment. RESULTS:ELA was successfully completed in 97% of patients. No crusting, epistaxis, or other complications were observed. One patient could not be treated in the office due to limited endoscopic access. TNSS was reduced significantly after30 and 90 days (mean ± SD: 6.0 ± 0.7 prior to ablation, 2.3 ± 0.4 at 90 days, p < .001). Rhinitis and congestion scores decreased at 30 and 90 days after treatment compared to the baseline (p < .001). CONCLUSION:ELA of the PNN region is safe and well tolerated both in the office and ambulatory settings. Symptom scores were significantly decreased after 30 and 90 days. This new minimally invasive method appears to be a promising treatment method.
Authors: J Pablo Stolovitzky; Randall A Ow; Stacey L Silvers; Nadim B Bikhazi; Curtis D Johnson; Masayoshi Takashima Journal: OTO Open Date: 2021-09-10
Authors: Jivianne T Lee; Gregory M Abbas; Daniel D Charous; Pd Dr Med Mandy Cuevas; Prof Dr Med Önder Göktas; Patricia A Loftus; Nathan E Nachlas; Elina M Toskala; Jeremy P Watkins; Prof Dr Med Detlef Brehmer Journal: Am J Rhinol Allergy Date: 2022-07-11 Impact factor: 2.300
Authors: Dale Ehmer; Chad M McDuffie; W Cooper Scurry; J Bradley McIntyre; Neelesh H Mehendale; John H Willis; Ronald B Shealy; Jeremy P Watkins; V Vasu Kakarlapudi Journal: Am J Rhinol Allergy Date: 2021-08-12 Impact factor: 2.467