Suture-based, Minimally Invasive Technique Used to Correct NSD

NCT ID: NCT04891263

Last Updated: 2023-04-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

4 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-08-02

Study Completion Date

2021-09-13

Brief Summary

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Nasal Septal Deviation (NSD) is one of the most common indications for surgery seen by ENT physicians, however, correction requires open surgery which is associated with several weeks of recovery. The purpose of this study is to elucidate whether a suture-based, minimally invasive technique can be used to safely and effectively address NSD.

Detailed Description

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Nasal obstruction due to structural issues such as nasal septal deviation (NSD) is remarkably common. NSD is caused by warping of the midline cartilage and bone of the septum, which starts between the 2 nostrils, and extends 7 cm posteriorly to the nasopharynx. This crooked or deviated conformation in the nasal septum cartilage and/or bone leads to physical blockade of normal airflow through the nose, often leading to complaints of nasal congestion, sleep disturbance, exercise limitations, and even poor compliance with CPAP mask use for treatment of obstructive sleep apnea (OSA). To correct this structural issue in symptomatic patients, septoplasty surgery under general anesthesia is typically advocated.

As an alternative to standard septoplasty, there are rare reports of simplified suture techniques that may be used to straighten the nasal septal cartilage. However, virtually all published studies to our knowledge have still required 1) some degree of cartilage/bone excision, which can destabilize the nasal support framework, and 2) use of non-locking sutures which can break, provide insufficient support, and be technically challenging given that it requires knot tying within the narrow nasal cavity corridors.

The investigators have demonstrated in benchtop models that similar results to standard septoplasty techniques can may be achieved with the use of a non-retractable suture without the need for cartilage excision. This technique, therefore, could allow for a simple, and knotless, minimally invasive way to improve and/or correct symptomatic NSD.

Conditions

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Nasal Septum; Deviation, Congenital Nasal Obstruction

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Suture-Septoplasty

Participants will receive suture-septoplasty technique, and will be followed for three months postoperatively.

Group Type EXPERIMENTAL

Suture-Septoplasty

Intervention Type PROCEDURE

Patients receive suture-septoplasty for repair of nasal septal deviation.

Surgical suture

Intervention Type DEVICE

Suture used for closure during septoplasty surgery.

Interventions

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Suture-Septoplasty

Patients receive suture-septoplasty for repair of nasal septal deviation.

Intervention Type PROCEDURE

Surgical suture

Suture used for closure during septoplasty surgery.

Intervention Type DEVICE

Other Intervention Names

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PDS suture

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 18
* Patients from all ethnic and geographic backgrounds within the Stanford Sinus Center with symptomatic NSD
* Primary patients with NSD without past septum surgery
* Patients who have failed maximum medical therapy
* Patients whose symptoms, examination and/or imaging findings are sufficiently severe as to warrant septoplasty as determined by the treating surgeon

Exclusion Criteria

* Age \< 18
* Recent surgery of any kind (\<1 month)
* Inpatients
* Previous nasal septum surgery
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Stanford University

OTHER

Sponsor Role lead

Responsible Party

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Jayakar Nayak

Associate Professor of Otolaryngology - Head & Neck Surgery (OHNS) and, by courtesy, of Neurosurgery at the Stanford University Medical Center

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jayakar V Nayak, M.D., Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Associate Professor of Otolaryngology - Head & Neck Surgery, Stanford University Medical Center

Locations

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Stanford Ambulatory Surgery Center, Stanford Hospital

Palo Alto, California, United States

Site Status

Stanford Sinus Center/ Adult Comprehensive ENT Clinic

Stanford, California, United States

Site Status

Countries

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United States

References

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van Egmond MMHT, Rovers MM, Hannink G, Hendriks CTM, van Heerbeek N. Septoplasty with or without concurrent turbinate surgery versus non-surgical management for nasal obstruction in adults with a deviated septum: a pragmatic, randomised controlled trial. Lancet. 2019 Jul 27;394(10195):314-321. doi: 10.1016/S0140-6736(19)30354-X. Epub 2019 Jun 18.

Reference Type BACKGROUND
PMID: 31227374 (View on PubMed)

Tan KH. Long-term survey of prominent ear surgery: a comparison of two methods. Br J Plast Surg. 1986 Apr;39(2):270-3. doi: 10.1016/0007-1226(86)90100-1.

Reference Type BACKGROUND
PMID: 3697576 (View on PubMed)

Rigg BM. Suture materials in otoplasty. Plast Reconstr Surg. 1979 Mar;63(3):409-10. doi: 10.1097/00006534-197903000-00022.

Reference Type BACKGROUND
PMID: 154115 (View on PubMed)

Boenisch M, Mink A. Clinical and histological results of septoplasty with a resorbable implant. Arch Otolaryngol Head Neck Surg. 2000 Nov;126(11):1373-7. doi: 10.1001/archotol.126.11.1373.

Reference Type BACKGROUND
PMID: 11074836 (View on PubMed)

Gruber RP, Nahai F, Bogdan MA, Friedman GD. Changing the convexity and concavity of nasal cartilages and cartilage grafts with horizontal mattress sutures: part I. Experimental results. Plast Reconstr Surg. 2005 Feb;115(2):589-94. doi: 10.1097/01.prs.0000150145.39509.db.

Reference Type BACKGROUND
PMID: 15692369 (View on PubMed)

Gruber RP, Nahai F, Bogdan MA, Friedman GD. Changing the convexity and concavity of nasal cartilages and cartilage grafts with horizontal mattress sutures: part II. Clinical results. Plast Reconstr Surg. 2005 Feb;115(2):595-606; discussion 607-8. doi: 10.1097/01.prs.0000150146.04465.81.

Reference Type BACKGROUND
PMID: 15692370 (View on PubMed)

Seo HJ, Denadai R, Vamvanij N, Chinpaisarn C, Lo LJ. Primary Rhinoplasty Does Not Interfere with Nasal Growth: A Long-Term Three-Dimensional Morphometric Outcome Study in Patients with Unilateral Cleft. Plast Reconstr Surg. 2020 May;145(5):1223-1236. doi: 10.1097/PRS.0000000000006744.

Reference Type BACKGROUND
PMID: 32332542 (View on PubMed)

Rohrich RJ, Friedman RM, Liland DL. Comparison of otoplasty techniques in the rabbit model. Ann Plast Surg. 1995 Jan;34(1):43-7. doi: 10.1097/00000637-199501000-00009.

Reference Type BACKGROUND
PMID: 7702300 (View on PubMed)

Boenisch M, Tamas H, Nolst Trenite GJ. Influence of polydioxanone foil on growing septal cartilage after surgery in an animal model: new aspects of cartilage healing and regeneration (preliminary results). Arch Facial Plast Surg. 2003 Jul-Aug;5(4):316-9. doi: 10.1001/archfaci.5.4.316.

Reference Type BACKGROUND
PMID: 12873869 (View on PubMed)

Other Identifiers

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57545

Identifier Type: -

Identifier Source: org_study_id

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