ABSTRACT
Background and Objectives@#This study aimed to elucidate the relationship between nasal septal deviation (NSD) and upper lateral cartilage (ULC) collapse. @*Methods@#We conducted a retrospective review of 142 paranasal sinus computed tomography scans from patients who had undergone septoplasty due to confirmed NSD. The ULC angle was measured on both the narrow and wide sides of the nasal cavities, and these measurements were compared to evaluate the extent of ULC collapse in relation to the degree of NSD and patient age. The correlation between the degree of NSD and the degree of ULC collapse was also analyzed. @*Results@#The mean ULC angle was found to be 13.4°±2.7° on the narrow side and 14.3°±2.7° on the wide side, with a statistically significant difference between the two (p<0.001). When comparing caudal and non-caudal NSD patients, there was no significant difference in the degree of ULC on either side (p=0.166). When comparing the ULC angle between two age groups (≥50 vs. <50 years), the difference in ULC angles was significantly greater in the group of patients aged under 50 years (0.3°±3.8° vs. 1.1°±2.2°, p=0.014). There was a significant positive correlation between the degree of ULC collapse and the degree of septal deviation (r=0.214, p=0.01). @*Conclusion@#NSD was associated with ULC collapse on the narrow side and a narrow internal nasal valve area. This result indicates that clinicians should check for concomitant ULC collapse in patients with NSD.
ABSTRACT
Background and Objectives@#Turbinoplasty may be an option in patients with persistent symptoms of allergic rhinitis (AR) despite adequate medication. The two most frequently used surgical techniques for turbinoplasty are radiofrequency ablation and microdebriderassisted turbinoplasty. This study compared the outcomes of these two surgical techniques and assessed the long-term treatment effects. @*Methods@#This study included patients with AR who underwent turbinoplasty between January 2010 and June 2017. We examined the medication scores, overall treatment satisfaction scores, and medical records. Based on the type of surgery, patients were classified into microdebrider and coblator groups. A telephone survey was conducted to collect data on the 5-year post-treatment efficacy parameters. Scores for allergic symptoms, prescription medicines taken after surgery, and general satisfaction were compared. @*Results@#Of the total 241 patients, 192 (79.7%) and 49 (20.3%) underwent microdebrider-assisted turbinoplasty and radiofrequency ablation turbinoplasty, respectively. Both the microdebrider and coblator groups showed remarkable improvements in AR symptoms at the 5-year follow-up (p<0.001). Although the degree of symptom improvement did not differ significantly between the two groups, the coblator group did show significant improvements in medication scores when compared with the microdebrider group (p<0.05), and there were significant differences in postoperative satisfaction scores between the two groups. @*Conclusion@#In terms of 5-year postoperative outcomes, radiofrequency-ablation turbinoplasty and microdebrider-assisted turbinoplasty were equally beneficial for reducing nasal symptoms and enhancing medication ratings in patients with AR.
ABSTRACT
Background and Objectives@#In 2021, biologics were approved for treating chronic rhinosinusitis with nasal polyps (CRSwNP) in Korea. However, CRS is a heterogeneous disease, and its characteristics are thought to differ between Western and Korean populations. This study aimed to evaluate the experiences of members of the Korean Rhinologic Society during the first year of biologic usage for the treatment of nasal polyps. @*Methods@#An anonymous survey consisting of 15 items was conducted from November to December 2021. The survey included questions about participant demographics, use of biologics for treating CRSwNP, and expectations regarding the effectiveness of biologics for treating CRSwNP. @*Results@#In total, 44 members participated in the survey. Approximately half of the respondents were in their 40s (50.0%) and had 5–9 years of clinical experience as otorhinolaryngologists (47.7%). The majority of participants held academic positions (95.4%). About half of them worked in Gyeonggi Province. The utilization of biologics did not differ significantly based on clinical experience (p=0.192). When asked about the factors considered for prescribing biologics, the most common reason was recurrence of polyps after surgery (87.2%). The most frequent reason for discontinuing biologics was cost (48.6%). When asked about the extent to which they expected that the availability of biologics for CRSwNP treatment would reduce endoscopic sinus surgery (ESS), 45.5% of members expected a reduction of approximately 10%–29%. In addition, 20.5% expected a reduction of 50% or more. However, 61.4% expected a reduction of less than 10% in primary ESS. In addition, most respondents (93.2%) agreed with the need for Korea-specific guidelines for biologic treatment. @*Conclusion@#There are discrepancies between the current guidelines for biologic treatment of CRSwNP and the reality of the situation, highlighting the need for the development of Korea-specific guidelines.
ABSTRACT
Well-characterized in chronic rhinosinusitis, type 2 inflammation is frequently associated with nasal polyps, comorbid asthma, and nonsteroidal anti-inflammatory drug hypersensitivity. Despite medical and surgical treatment, it recurs in a significant proportion of patients. Thus, severe uncontrolled type 2 chronic rhinosinusitis with nasal polyps is the most difficult-to-treat phenotype of chronic rhinosinusitis. Recently, dupilumab, a monoclonal antibody against IL-4 receptor α, and omalizumab, a monoclonal antibody against immunoglobulin E, were approved for patients with chronic rhinosinusitis with nasal polyps in the United States, Europe, and Korea. Therefore, rhinologists should understand novel biologics and their use. Here, we provide a literature review of several biologics with their indications, effectiveness, and safety.