Evaluating post-rhinoplasty nasal obstruction treatment: The efficacy of VivAer radiofrequency ablation

Jordan K Simmons; Wasiq Nadeem; Victor B Hsue; Henry H Chen; Matthew K Lee

doi:10.1016/j.amjoto.2024.104338

Evaluating post-rhinoplasty nasal obstruction treatment: The efficacy of VivAer radiofrequency ablation

Am J Otolaryngol. 2024 Apr 26;45(4):104338. doi: 10.1016/j.amjoto.2024.104338. Online ahead of print.

Authors

Jordan K Simmons¹, Wasiq Nadeem¹, Victor B Hsue¹, Henry H Chen¹, Matthew K Lee²

Affiliations

¹ Division of Otolaryngology, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America.
² Division of Otolaryngology, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America. Electronic address: matthew.lee@cshs.org.

PMID: 38729012
DOI: 10.1016/j.amjoto.2024.104338

Abstract

Purpose: Nasal obstruction is a prevalent issue affecting up to one-third of adults, often requiring surgical intervention. Low-temperature radiofrequency (RF) treatment, specifically VivAer, has emerged as a promising alternative, especially for the treatment of nasal valve collapse (NVC). However, its efficacy in patients with a history of rhinoplasty or nasal valve repair remains unexplored.

Methods: A single-center retrospective chart review was conducted on 37 patients with a history of rhinoplasty or nasal valve repair who underwent VivAer RF treatment. Treatment outcomes were assessed using the Nasal Obstruction Symptom Evaluation (NOSE) scale. The primary outcome was defined as a decrease in NOSE score by at least one severity category or a 20 % reduction in total NOSE score.

Results: The study found a statistically significant average reduction in NOSE score of 22.4 points or 36.6 %. Among patients with a positive treatment response (21 patients or 56.8 %), the average NOSE score reduction was 34.7 points or 55.6 %. Repeat RF treatment in non-responders resulted in a 50 % response rate. No significant difference was observed in treatment outcomes based on the type of prior rhinoplasty or NVC.

Conclusions: Temperature-controlled RF treatment with VivAer can effectively alleviate nasal obstruction in patients with a history of rhinoplasty or nasal valve repair, offering a viable alternative to revision surgery. The study also highlights the potential benefit of repeat RF treatment in non-responders. Further research, including randomized controlled trials, is needed to validate these promising results and expand the treatment options for this complex patient population.

Keywords: Lateral wall insufficiency; Nasal obstruction; Nasal valve collapse; Radiofrequency ablation; Rhinoplasty; VivAer.