Guled M Jama, Filippo Cainelli, Luiza Farache Trajano, Peter J Andrews, Hesham Saleh
{"title":"微创技术治疗鼻瓣膜功能障碍:系统回顾和荟萃分析。","authors":"Guled M Jama, Filippo Cainelli, Luiza Farache Trajano, Peter J Andrews, Hesham Saleh","doi":"10.1055/a-2689-1750","DOIUrl":null,"url":null,"abstract":"<p><p>Nasal valve dysfunction (NVD) is a prevalent cause of nasal obstruction, significantly impacting quality of life. In recent years, the emergence of office-based interventions has transformed the therapeutic landscape for this condition, offering patients a wider choice and less invasive options compared to traditional surgical methods, yet their comparative safety and efficacy remain to be fully established.A systematic review and meta-analysis were conducted in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Four databases (PubMed, Scopus, Cochrane Library, and Ovid) were searched for original studies (2005-2025) assessing minimally invasive treatments for NVD with patient-reported outcomes. Random-effects meta-analyses evaluated changes in Nasal Obstruction Symptom Evaluation (NOSE) and Visual Analog Scale (VAS) scores.Fifteen studies comprising 546 patients were included, evaluating temperature-controlled radiofrequency (TCRF), bioabsorbable implants, intranasal suturing techniques, and nasal valve stenting. TCRF yielded a weighted mean difference (WMD) in NOSE scores of -44.68 (95% confidence interval [CI]: -51.23 to -38.13; <i>p</i> < 0.001), while bioabsorbable implants achieved a WMD of -39.91 (95% CI: -48.53 to -31.29; <i>p</i> < 0.001). Intranasal suturing demonstrated a VAS WMD of -4.36 (95% CI: -4.88 to -3.84; <i>p</i> < 0.001). All interventions surpassed minimal clinically important differences, with adverse events being relatively mild and transient. Improvements were sustained across all modalities over a follow-up period of 3 to 48 months (<i>I</i> <sup>2</sup> = 63.9-89.7%).Minimally invasive techniques for NVD demonstrate statistically and clinically significant and durable symptom relief with favorable safety profiles. These interventions may offer viable alternatives to traditional surgical approaches, particularly in select patients seeking reduced morbidity and procedural complexity. Future research should prioritize randomized comparisons and standardized outcome metrics.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.4000,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Minimally Invasive Techniques for Nasal Valve Dysfunction: A Systematic Review and Meta-Analysis.\",\"authors\":\"Guled M Jama, Filippo Cainelli, Luiza Farache Trajano, Peter J Andrews, Hesham Saleh\",\"doi\":\"10.1055/a-2689-1750\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Nasal valve dysfunction (NVD) is a prevalent cause of nasal obstruction, significantly impacting quality of life. In recent years, the emergence of office-based interventions has transformed the therapeutic landscape for this condition, offering patients a wider choice and less invasive options compared to traditional surgical methods, yet their comparative safety and efficacy remain to be fully established.A systematic review and meta-analysis were conducted in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Four databases (PubMed, Scopus, Cochrane Library, and Ovid) were searched for original studies (2005-2025) assessing minimally invasive treatments for NVD with patient-reported outcomes. Random-effects meta-analyses evaluated changes in Nasal Obstruction Symptom Evaluation (NOSE) and Visual Analog Scale (VAS) scores.Fifteen studies comprising 546 patients were included, evaluating temperature-controlled radiofrequency (TCRF), bioabsorbable implants, intranasal suturing techniques, and nasal valve stenting. TCRF yielded a weighted mean difference (WMD) in NOSE scores of -44.68 (95% confidence interval [CI]: -51.23 to -38.13; <i>p</i> < 0.001), while bioabsorbable implants achieved a WMD of -39.91 (95% CI: -48.53 to -31.29; <i>p</i> < 0.001). Intranasal suturing demonstrated a VAS WMD of -4.36 (95% CI: -4.88 to -3.84; <i>p</i> < 0.001). All interventions surpassed minimal clinically important differences, with adverse events being relatively mild and transient. Improvements were sustained across all modalities over a follow-up period of 3 to 48 months (<i>I</i> <sup>2</sup> = 63.9-89.7%).Minimally invasive techniques for NVD demonstrate statistically and clinically significant and durable symptom relief with favorable safety profiles. These interventions may offer viable alternatives to traditional surgical approaches, particularly in select patients seeking reduced morbidity and procedural complexity. Future research should prioritize randomized comparisons and standardized outcome metrics.</p>\",\"PeriodicalId\":12195,\"journal\":{\"name\":\"Facial Plastic Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-09-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Facial Plastic Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1055/a-2689-1750\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Facial Plastic Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-2689-1750","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
鼻瓣膜功能障碍(NVD)是鼻塞的常见原因,严重影响生活质量。近年来,以办公室为基础的干预措施的出现改变了这种疾病的治疗前景,与传统的手术方法相比,为患者提供了更广泛的选择和更少的侵入性选择,但其相对安全性和有效性仍有待完全确定。根据系统评价和元分析(PRISMA)指南的首选报告项目进行系统评价和元分析。检索了四个数据库(PubMed、Scopus、Cochrane Library和Ovid),检索了2005-2025年评估微创治疗NVD患者报告结果的原始研究。随机效应荟萃分析评估鼻塞症状评估(NOSE)和视觉模拟量表(VAS)评分的变化。包括546例患者的15项研究,评估了温控射频(TCRF)、生物可吸收植入物、鼻内缝合技术和鼻瓣膜支架置入。TCRF的加权平均差值(WMD)为-44.68(95%可信区间[CI]: -51.23 ~ -38.13; p p p I 2 = 63.9 ~ 89.7%)。微创技术治疗NVD具有统计学和临床意义,持久的症状缓解,具有良好的安全性。这些干预措施可能为传统手术方式提供可行的替代方案,特别是在寻求降低发病率和手术复杂性的特定患者中。未来的研究应优先考虑随机比较和标准化的结果指标。
Minimally Invasive Techniques for Nasal Valve Dysfunction: A Systematic Review and Meta-Analysis.
Nasal valve dysfunction (NVD) is a prevalent cause of nasal obstruction, significantly impacting quality of life. In recent years, the emergence of office-based interventions has transformed the therapeutic landscape for this condition, offering patients a wider choice and less invasive options compared to traditional surgical methods, yet their comparative safety and efficacy remain to be fully established.A systematic review and meta-analysis were conducted in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Four databases (PubMed, Scopus, Cochrane Library, and Ovid) were searched for original studies (2005-2025) assessing minimally invasive treatments for NVD with patient-reported outcomes. Random-effects meta-analyses evaluated changes in Nasal Obstruction Symptom Evaluation (NOSE) and Visual Analog Scale (VAS) scores.Fifteen studies comprising 546 patients were included, evaluating temperature-controlled radiofrequency (TCRF), bioabsorbable implants, intranasal suturing techniques, and nasal valve stenting. TCRF yielded a weighted mean difference (WMD) in NOSE scores of -44.68 (95% confidence interval [CI]: -51.23 to -38.13; p < 0.001), while bioabsorbable implants achieved a WMD of -39.91 (95% CI: -48.53 to -31.29; p < 0.001). Intranasal suturing demonstrated a VAS WMD of -4.36 (95% CI: -4.88 to -3.84; p < 0.001). All interventions surpassed minimal clinically important differences, with adverse events being relatively mild and transient. Improvements were sustained across all modalities over a follow-up period of 3 to 48 months (I2 = 63.9-89.7%).Minimally invasive techniques for NVD demonstrate statistically and clinically significant and durable symptom relief with favorable safety profiles. These interventions may offer viable alternatives to traditional surgical approaches, particularly in select patients seeking reduced morbidity and procedural complexity. Future research should prioritize randomized comparisons and standardized outcome metrics.
期刊介绍:
Facial Plastic Surgery is a journal that publishes topic-specific issues covering areas of aesthetic and reconstructive plastic surgery as it relates to the head, neck, and face. The journal''s scope includes issues devoted to scar revision, periorbital and mid-face rejuvenation, facial trauma, facial implants, rhinoplasty, neck reconstruction, cleft palate, face lifts, as well as various other emerging minimally invasive procedures.
Authors provide a global perspective on each topic, critically evaluate recent works in the field, and apply it to clinical practice.