Michelle H Kim, Nathan A Luzum, Adam J Kimple, Anna C Zemke, Dennis Frank-Ito
{"title":"elexaftor /Tezacaftor/Ivacaftor对囊性纤维化患者鼻空域的影响。","authors":"Michelle H Kim, Nathan A Luzum, Adam J Kimple, Anna C Zemke, Dennis Frank-Ito","doi":"10.1002/lary.70156","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>Median (IQR) surface area and volume increased significantly from pre-ETI (Surface Area: 251.97 cm<sup>2</sup> (43.71); Volume: 44.86 cm<sup>3</sup> (20.72)) to post-ETI (Surface Area: 295.77 cm<sup>2</sup> (31.34); Volume: 61.03 cm<sup>3</sup> (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<sup>-1</sup> (0.007); post-ETI: 0.052 cm<sup>-1</sup> (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).</p><p><strong>Conclusion: </strong>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.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effects of Elexacaftor/Tezacaftor/Ivacaftor on the Sinonasal Airspace in Cystic Fibrosis.\",\"authors\":\"Michelle H Kim, Nathan A Luzum, Adam J Kimple, Anna C Zemke, Dennis Frank-Ito\",\"doi\":\"10.1002/lary.70156\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>Median (IQR) surface area and volume increased significantly from pre-ETI (Surface Area: 251.97 cm<sup>2</sup> (43.71); Volume: 44.86 cm<sup>3</sup> (20.72)) to post-ETI (Surface Area: 295.77 cm<sup>2</sup> (31.34); Volume: 61.03 cm<sup>3</sup> (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<sup>-1</sup> (0.007); post-ETI: 0.052 cm<sup>-1</sup> (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).</p><p><strong>Conclusion: </strong>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.</p><p><strong>Level of evidence: 4: </strong></p>\",\"PeriodicalId\":49921,\"journal\":{\"name\":\"Laryngoscope\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-09-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Laryngoscope\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/lary.70156\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laryngoscope","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/lary.70156","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
Effects of Elexacaftor/Tezacaftor/Ivacaftor on the Sinonasal Airspace in Cystic Fibrosis.
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.
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
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