Strip electrodes: a novel, effective and minimally invasive therapeutic option for correcting DNS via electromechanical reshaping†

Abstract

Deviated nasal septum (DNS) is a common condition affecting nasal breathing, which is generally treated using septoplasty. However, this invasive surgical method carries potential risks of post-surgical complications. Alternatively, electromechanical reshaping (EMR) is a novel method that has evolved as a non-thermal, minimally invasive option to reshape the cartilage using mechanical pressure and direct current (DC) without significant tissue damage. However, the existing flat and needle electrodes tested in animal tissues have raised significant concerns due to their safety. Thus, herein, we aimed to develop a novel strip electrode configuration and optimize dosimetry to achieve efficient reshaping without compromising its safety. Electric field simulations showed that our novel 5-strip electrode configuration with a thickness of 0.5 mm achieved optimal electric field, requiring minimal current flow compared to flat electrodes. EMR was performed on ex vivo goat cartilage at various dosimetry groups to analyze four-day shape retention. The optimized strip electrode reshaped the ex vivo goat septal cartilage effectively at a dosimetry of 20 mA for 15 minutes, whereas the flat electrode needed 35 mA for 15 minutes. DMMB assay, ATR-FTIR spectroscopy, tensile testing, and histopathology analysis demonstrated reduced tissue damage while supporting increased efficiency and mechanical stability with the strip electrode configuration, emphasizing its safety. Thus, the optimized strip electrode-based EMR emerges as a viable non-invasive approach for reshaping the nasal septal cartilage, which can be used to treat DNS. Further in vivo studies are recommended to validate the long-term safety and efficacy of this technique.