Objective and Subjective Outcomes Following Radiofrequency of Inferior Turbinates in Patients with Sleep-Disordered Breathing
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Participants’ Characteristics
2.3. Details of the Surgery
2.4. Objective and Subjective Measurements at Baseline and Follow-Ups
2.5. Statistical Analysis
3. Results
3.1. Breakdown of the Population
3.2. Demographic Data
3.3. Nasal Airflow and Olfactory Function at Baseline
3.4. Other Investigations at Baseline
3.5. Patient-Reported Outcome Measures (PROMs)
3.6. Changes at Follow-up
3.7. Influence of Available Variables on Studied Parameters
4. Discussion
Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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n = 17 | |
---|---|
Demographics | |
Age, median [P25–P75], year | 42.0 [35.0–52.0] |
Sex, No (%) | |
Female | 7 (41.2%) |
Male | 10 (58.8%) |
Smoking status, No (%) | |
Ex-smoker | 1 (5.9%) |
Active | 1 (5.9%) |
No | 15 (88.2%) |
History of rhinitis, No (%) | |
Allergic type | 9 (52.9%) |
Non-allergic type | 8 (47.1%) |
Sleep symptoms, No (%) | |
Snoring only | 5 (29.4%) |
OSA only | 0 (0.0%) |
Both | 12 (70.6%) |
Comorbidities, No (%) | |
None | 7 (41.2%) |
Asthma | 4 (23.5%) |
Hypertension | 3 (17.6%) |
Mental health issues | 3 (17.6%) |
Other | 5 (29.4%) |
Medications, No (%) | |
Nasal douche | 17 (100%) |
Steroid spray | 8 (47.1%) |
Steroid + antihistamine spray | 9 (52.9%) |
Sartan | 2 (11.8%) |
Beta-2 agonist inhaler | 4 (23.5%) |
Other | 5 (29.4%) |
Previous relevant surgery, No (%) | |
Tonsillectomy | 3 (17.6%) |
Palatoplasty | 2 (11.8%) |
Rhinoplasty | 2 (11.8%) |
Septoplasty | 1 (5.9%) |
Investigations | |
Skin prick test, No (%) | |
Negative | 8 (47.1%) |
One allergen | 3 (17.6%) |
Two allergens | 2 (11.8%) |
Multiple allergens | 4 (23.5%) |
Nasal endoscopy findings, No (%) | |
Rhinitis | 17 (100%) |
IT hypertrophy only | 9 (52.9%) |
Septal deviation + IT hypertrophy | 8 (47.1%) |
Baseline (T0) n = 17 | 3-Month (T1) n = 13 | 6-Month (T2) n = 14 | 12-Month (T3) n = 10 | p-Value (T0–T1) | p-Value (T0–T2) | p-Value (T0–T3) | |
---|---|---|---|---|---|---|---|
Nasal measurements | |||||||
Pre-decongestion | |||||||
PNIF, median [P25–P75], L/min | |||||||
Bilateral PNIF | 130.0 [90.0–160.0] | 115.0 [107.5–120.0] | 130.0 [120.0–157.5] | 135.0 [93.8–147.5] | 0.80 | 0.83 | 0.83 |
Right PNIF | 95.0 [50.0–140.0] | 65.0 [50.0–82.5] | 100.0 [60.0–125.0] | 75.0 [52.5–98.8] | 0.50 | 0.70 | 0.68 |
Left PNIF | 80.0 [45.0–120.0] | 65.0 [53.8–85.0] | 72.5 [60.0–107.5] | 77.5 [61.3–88.8] | 0.66 | 0.92 | 0.76 |
Acoustic rhinometry, median [P25–P75] | |||||||
Right MCA1, cm2 | 0.8 [0.4–1.1] | 0.6 [0.5–1.0] | 0.9 [0.5–1.0] | 0.6 [0.6–0.9] | 0.50 | 0.85 | 0.28 |
Right nasal volume (0–5), cm3 | 6.1 [4.5–9.5] | 7.8 [6.2–12.6] | 6.8 [5.9–10.0] | 6.2 [5.4–7.8] | 0.03 * | 0.90 | 0.49 |
Left MCA1, cm2 | 0.5 [0.4–0.8] | 0.7 [0.5–1.0] | 0.7 [0.5–0.8] | 0.6 [0.5–0.9] | 0.02 * | 0.19 | 0.82 |
Left nasal volume (0–5), cm3 | 6.2 [5.1–8.1] | 8.2 [5.8–9.5] | 8.3 [5.7–10.5] | 6.4 [4.2–8.0] | 0.02 * | 0.09 | 0.50 |
Post-decongestion | |||||||
PNIF, median [P25–P75], L/min | |||||||
Bilateral PNIF | 150.0 [110.0–180.0] | 120.0 [110.0–170.0] | 150.0 [125.0–200.0] | 140.0 [122.5–155.0] | 0.58 | 0.72 | 0.72 |
Right PNIF | 110.0 [85.0–130.0] | 75.0 [60.0–110.0] | 80.0 [70.0–135.0] | 97.5 [70.0–128.8] | 0.69 | 0.47 | 0.26 |
Left PNIF | 100.0 [50.0–140.0] | 85.0 [65.0–100.0] | 85.0 [60.0–110.0] | 100.0 [76.3–100.0] | 0.72 | 0.46 | 1.00 |
Acoustic rhinometry, median [P25–P75] | |||||||
Right MCA1, cm2 | 1.0 [0.8–1.5] | 0.9 [0.8–1.1] | 0.9 [0.8–1.3] | 1.1 [0.7–1.3] | 0.79 | 0.54 | 0.37 |
Right nasal volume (0–5), cm3 | 9.4 [6.0–11.9] | 9.3 [7.7–10.9] | 8.2 [7.1–11.2] | 8.7 [7.3–10.5] | 0.24 | 0.95 | 0.84 |
Left MCA1, cm2 | 0.9 [0.6–1.1] | 1.0 [0.5–1.2] | 1.0 [0.9–1.1] | 1.1 [0.9–1.1] | 0.19 | 0.13 | 0.23 |
Left nasal volume (0–5), cm3 | 9.5 [6.6–11.6] | 9.1 [6.3–12.1] | 10.1 [6.2–10.7] | 9.9 [8.5–12.0] | 0.78 | 0.79 | 1.00 |
Baseline (T0) n = 17 | 3 Month (T1) n = 13 | 6 Month (T2) n = 14 | 12 Month (T3) n = 10 | p-Value (T0–T1) | p-Value (T0–T2) | p-Value (T0–T3) | |
---|---|---|---|---|---|---|---|
Other measurements | |||||||
Sniffin’ Sticks Identification, median [P25–P75] | 13.0 [11.0–13.0] | 12.0 [11.0–14.0] | 12.5 [11.3–13.0] | 13.0 [11.0–13.0] | 0.63 | 0.93 | 0.10 |
Normosmics, n (%) | 13 (76.5%) | 11 (84.6%) | 12 (85.7%) | 9 (90.0%) | 0.38 | 0.20 | 0.10 |
Hyposmics, n (%) | 4 (23.5%) | 2 (15.4%) | 2 (14.3%) | 1 (10.0%) | 1.00 | 0.37 | N/A + |
BMI, median [P25–P75], kg/m2 | 30.1 [26.5–32.8] | - | 27.1 [25.5–32.0] | - | - | - | |
Normal range (18.5–24.9), n (%) | 2 (14.3%) | 3 (23.1%) | 0.47 | ||||
Overweight, (25–29.9), n (%) | 5 (35.7%) | 5 (38.5%) | 0.93 | ||||
Obese grade I, (30–34.9), n (%) | 4 (28.6%) | 3 (23.1%) | 1 | ||||
Obese grade II, (35–39.9), n (%) | 2 (14.3%) | 1 (7.7%) | 1 | ||||
Obese grade III, (≥40), n (%) | 1 (7.1%) | 1 (7.7%) | 1 | ||||
Missing | 3 | 4 | 1 | ||||
Sleep Study | - | - | - | - | |||
AHI, median [P25–P75] | 12.3 [4.7–17.2] | 11.0 [2.8–16.3] | 0.42 | ||||
Normal (<5), n (%) | 5 (29.4%) | 5 (33.3%) | 1 | ||||
Mild OSA (5–14.9), n (%) | 5 (29.4%) | 5 (33.3%) | 1 | ||||
Moderate OSA, (15–29.9), n (%) | 6 (35.3%) | 4 (26.7%) | 0.89 | ||||
Severe OSA (≥30), n (%) | 1 (5.9%) | 1 (6.7%) | 1 | ||||
ODI, median [P25–P75] | 10.5 [3.7–14.6] | 9.2 [2.4–14.3] | 0.48 | ||||
Snore percentage, median [P25–P75] | 24.3 [5.6–36.5] | 13.8 [2.0–29.7] | 0.89 | ||||
Missing | 0 | 2 | |||||
PROMs | |||||||
SF-36, median [P25–P75], % | |||||||
Physical functioning | 90.0 [80.0–100] | 85.0 [60.0–95.0] | 90.0 [70.0–100] | 90.0 [85.0–100] | 0.15 | 0.94 | 0.41 |
Role limitations due to physical health | 100 [25.0–100] | 100 [62.5–100] | 100 [75.0–100] | 100 [50.0–100] | 0.58 | 0.34 | 1.00 |
Role limitations due to emotional problems | 100 [33.3–100] | 100 [50.0–100] | 100 [100–100] | 100 [100–100] | 0.79 | 0.09 | 0.37 |
Energy/Fatigue | 50.0 [45.0–65.0] | 45.0 [42.5–65.0] | 45.0 [35.0–70.0] | 50.0 [40.0–65.0] | 0.73 | 0.97 | 0.83 |
Emotional wellbeing | 80.0 [56.0–88.0] | 76.0 [62.0–76.0] | 76.0 [64.0–84.0] | 84.0 [48.0–88.0] | 0.93 | 0.30 | 0.32 |
Social functioning | 81.3 [50.0–90.6] | 75.0 [50.0–75] | 75.0 [62.5–100] | 87.5 [62.5–100] | 0.26 | 0.55 | 0.46 |
Pain | 78.8 [45.0–82.5] | 77.5 [61.3–95.0] | 77.5 [57.5–90.0] | 67.5 [67.5–77.5] | 0.41 | 0.76 | 0.17 |
General health | 60.0 [40.0–70.0] | 60.0 [35.0–65.0] | 65.0 [55.0–75.0] | 65.0 [35.0–70.0] | 0.33 | 0.08 | 0.80 |
Health change | 50.0 [25.0–75.0] | 50.0 [50.0–62.5] | 50.0 [50.0–75.0] | 50.0 [50.0–75.0] | 0.17 | 0.85 | 0.42 |
Epworth sleepiness scale, median [P25–P75] | 8.0 [5.0–13.0] | 9.0 [4.5–15.0] | 4.0 [2.5–10.5] | 4.0 [3.0–10.0] | 0.55 | 0.07 | 0.20 |
Short-QODNS, median [P25–P75] | 21.0 [15.5–21.0] | 20.0 [15.0–21.0] | 20.0 [15.3–21.0] | 18.5 [15.3–21.0] | 0.78 | 0.85 | 1.00 |
sVAS, median [P25–P75] | 7.5 [7.0–10] | 8.0 [7.0–10] | 8.0 [7.0–10] | 8.0 [6.5–10.0] | 0.34 | 0.68 | 0.72 |
SNOT-22, median [P25–P75] | 31.0 [24.5–48.5] | 36.0 [29.5–48.5] | 22.5 [18.8–40.3] | 25.0 [20.0–47.0] | 0.49 | 0.42 | 0.55 |
NOSE, median [P25–P75] | 14.0 [9.3–18.3] | 14.0 [9.5–15.0] | 7.0 [6.5–9.8] | 10.0 [7.0–13.0] | 0.03 * | 0.09 | 0.83 |
Age | Sex (Male) | BMI | Septal Deviation | Non-Allergic Rhinitis | Random Effect (Patient) | |
---|---|---|---|---|---|---|
PNIF | ||||||
Bilateral | 1.60 | |||||
Right | 1.34 | |||||
Left | −0.10 * | −0.22 *** | −2.42 ** | |||
Acoustic Rhinometry | ||||||
Right MCA1 | −0.03 ** | |||||
Left MCA1 | +0.60 *** | +0.54 *** | ||||
Right NV | −0.03 ** | |||||
Left NV | +2.43 * | +2.22 * | 1.56 | |||
AHI | −19.9 *** | |||||
Epworth sleepiness scale | −1.30 | −2.63 | −2.41 | 4.87 | ||
SNOT-22 | −5.42 | +0.92 | +1.29 | −11.28 | 13.65 | |
NOSE | −6.94 ** | +1.01 | −4.49 | 1.30 | ||
sVAS | 1.39 | |||||
Sniffin’ Sticks (Identification) | −2.25 *** |
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© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Pendolino, A.L.; Unadkat, S.; Cheong, R.C.T.; Patel, A.; Ferreira, J.; Scarpa, B.; Andrews, P.J. Objective and Subjective Outcomes Following Radiofrequency of Inferior Turbinates in Patients with Sleep-Disordered Breathing. Diagnostics 2024, 14, 1820. https://doi.org/10.3390/diagnostics14161820
Pendolino AL, Unadkat S, Cheong RCT, Patel A, Ferreira J, Scarpa B, Andrews PJ. Objective and Subjective Outcomes Following Radiofrequency of Inferior Turbinates in Patients with Sleep-Disordered Breathing. Diagnostics. 2024; 14(16):1820. https://doi.org/10.3390/diagnostics14161820
Chicago/Turabian StylePendolino, Alfonso Luca, Samit Unadkat, Ryan Chin Taw Cheong, Ankit Patel, Joshua Ferreira, Bruno Scarpa, and Peter J. Andrews. 2024. "Objective and Subjective Outcomes Following Radiofrequency of Inferior Turbinates in Patients with Sleep-Disordered Breathing" Diagnostics 14, no. 16: 1820. https://doi.org/10.3390/diagnostics14161820