title: Treatment of nasal valve collapse with transcutaneous and intranasal electric stimulation.
abstract: We conducted a prospective, randomized, double-blind pilot study of patients presenting with symptoms of obstructed nasal breathing to determine whether electrotherapy could provide nonsurgical symptom relief. Forty patients were divided into an electrotherapy group (n = 20) and a placebo group (n = 20). All selected patients demonstrated nasal valve stenosis with a positive Cottle maneuver and clinically evident nasal valve collapse. Treatment consisted of high-frequency transcutaneous and intranasal electric stimulation of nasal muscles for 15 minutes, 3 times a week for 10 weeks. Treated patients were followed for 10 to 12 months. Twelve patients in the electrotherapy group (60%) exhibited subjective improvement; in 8 cases (40%), the improvement was proved objectively. In the placebo group, 7 patients (35%) indicated subjective improvement; and in one case (50%), the improvement was proved objectively. Follow-up visits showed a rapid decline of positive results when treatment was discontinued. Therefore, we concluded that sure relief of nasal valve stenosis and collapse cannot be achieved with treatment by electric stimulation alone, and this method appears to have limited application. However, further studies are needed to determine whether electrotherapy used in combination with other treatments (e.g., biofeedback training or nasal springs) may provide more lasting relief for patients who want to avoid endonasal surgical intervention.
authors.affiliation: Department of Otolaryngology, Assaf Harofeh Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel. Shteren20@hotmail.com
authors.forename: Michael
authors.initials: M
authors.lastname: Vaiman
authors.forename: Nathan
authors.initials: N
authors.lastname: Shlamkovich
authors.forename: Ephraim
authors.initials: E
authors.lastname: Eviatar
authors.forename: Samuel
authors.initials: S
authors.lastname: Segal
mesh_terms: D000328:Adult; D003251:Constriction, Pathologic / Q000628:therapy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000628:therapy*; D009300:Nasal Septum; D010865:Pilot Projects; D004561:Transcutaneous Electric Nerve Stimulation