Effects of Elexacaftor/Tezacaftor/Ivacaftor on the Sinonasal Airspace in Cystic Fibrosis.

IF 2 3区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Laryngoscope Pub Date : 2025-09-25 DOI:10.1002/lary.70156

Michelle H Kim, Nathan A Luzum, Adam J Kimple, Anna C Zemke, Dennis Frank-Ito

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引用次数: 0

Abstract

Objectives: People with Cystic Fibrosis (CF) experience significant sinonasal airway opacification, leading to chronic airway-related conditions. The triple combination therapy Elexacaftor/Tezacaftor/Ivacaftor (ETI) has emerged as a therapeutic option for CF. This study uses volumetric quantification technique to evaluate changes in CF sinonasal airway patency pre-ETI and post-ETI.

Methods: Anatomically accurate person-specific three-dimensional sinonasal airspaces were reconstructed from radiographical images of 19 people (12 male, 7 female) with CF, pre-ETI and post-ETI. Sinonasal airspace surface area, volume, and surface-area-to-volume ratio were calculated pre-ETI and post-ETI. Pre-ETI and post-ETI sinonasal airspace changes in these computed parameters were corrected with changes in both Lund-Mackay and SNOT-22 scores.

Results: Median (IQR) surface area and volume increased significantly from pre-ETI (Surface Area: 251.97 cm² (43.71); Volume: 44.86 cm³ (20.72)) to post-ETI (Surface Area: 295.77 cm² (31.34); Volume: 61.03 cm³ (14.21)), with respective p < 0.01 per computed parameter. Furthermore, median surface-area-to-volume ratio (IQR) was significantly different; pre-ETI: 0.053 cm^-1 (0.007); post-ETI: 0.052 cm^-1 (0.013); p = 0.04. Pre-ETI to post-ETI improvement changes in surface area and volume significantly correlated with corresponding changes in Lund-Mackay scores (Surface Area: R = -0.78, p < 0.01; Volume: R = -0.68, p < 0.01), but correlated weakly with corresponding changes in patient-reported SNOT-22 scores (Surface Area: R = -0.13, p = 0.62; Volume: R = -0.06, p = 0.82).

Conclusion: People with CF treated with ETI exhibited a significant increase in sinonasal airway patency, as evidenced by volumetric quantification analysis of surface area and volume differences. These increases in both parameters showed strong significant correlations with Lund-Mackay scores; however, no such correlations were observed with SNOT-22 scores.

Level of evidence: 4:

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elexaftor /Tezacaftor/Ivacaftor对囊性纤维化患者鼻空域的影响。

目的：囊性纤维化（CF）患者会出现明显的鼻窦气道混浊，导致慢性气道相关疾病。三联疗法elexaftor /Tezacaftor/Ivacaftor （ETI）已成为CF的一种治疗选择。本研究使用体积量化技术评估CF在ETI前和ETI后鼻气道通畅的变化。方法：对19例CF患者（男12例，女7例）、eti前和eti后的x线图像进行解剖准确的个体化三维鼻窦空间重建。计算了探测前和探测后鼻腔空域表面积、体积和表面积体积比。这些计算参数在eti前和eti后的鼻腔空域变化用Lund-Mackay和SNOT-22评分的变化进行校正。结果：中位（IQR）表面积和体积较eti前显著增加(表面积：251.97 cm2 (43.71)；体积：44.86 cm3(20.72))至eti后(表面积：295.77 cm2 (31.34)；体积：61.03 cm3(14.21))，分别p -1 (0.007)；后eti: 0.052 cm-1 (0.013)；p = 0.04。ETI前到ETI后的改善，表面积和体积的变化与相应的Lund-Mackay评分的变化显著相关（表面积：R = -0.78, p）结论：经ETI治疗的CF患者鼻窦气道通畅显著增加，这可以通过对表面积和体积差异的体积量化分析得到证明。这两个参数的增加都与隆德-麦凯评分有很强的显著相关性；然而，与SNOT-22评分没有观察到这种相关性。证据等级：4；

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Laryngoscope 医学-耳鼻喉科学

CiteScore

6.50

自引率

7.70%

发文量

500

审稿时长

2-4 weeks

期刊介绍： The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope. • Broncho-esophagology • Communicative disorders • Head and neck surgery • Plastic and reconstructive facial surgery • Oncology • Speech and hearing defects