Does Batten Grafting Improve Nasal Outcomes in Septoplasty and Turbinate Reduction?

NCT ID: NCT05287841

Last Updated: 2024-09-20

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

RECRUITING

Clinical Phase

NA

Total Enrollment

96 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-04-30

Study Completion Date

2025-06-15

Brief Summary

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The objective of this study is to compare the effectiveness of batten grafts plus septoplasty and turbinate reduction (intervention arm) compared to septoplasty and turbinate reduction alone (control arm), both in terms of subjective and objective assessments.

Detailed Description

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One of the most common reasons to pursue nasal surgery is for nasal obstruction caused by a septal deviation. Otolaryngologists frequently perform septoplasties to improve nasal obstruction due to septal deviation, leading to improved airflow and decrease office visits and medication use. Concurrently with septal deviations, the inferior turbinate tends to become hypertrophied on the contralateral side potentially causing additional nasal obstruction. While septal deviations and inferior turbinate hypertrophy are more anatomical causes of nasal obstruction, there are also other types that vary depending on nasal airflow, such as nasal valve collapse. One way to surgically correct such dynamic nasal obstruction includes alar batten grafts. These grafts are not meant to change the anatomy of the nose, but instead, function to support the weakened lateral wall. Expanding the current septoplasty procedure to include batten grafts as well as inferior turbinate reduction could possibly improve long-term outcomes, especially reducing future surgeries.

Conditions

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Nasal Obstruction Septal Defect Allergic Rhinitis Nasal Polyps Nasal Valve Collapse

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The total number of subjects to be accrued locally is 96. We expect 96 patients to be pre-screened, enrolled (consent obtained), randomized, and complete research procedures. Each arm will have 48 patients. 48 patients in two arms for total of 96 patients.
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Batten graft, plus septoplasty and inferior turbinate reduction

In the intervention arm, a portion of the quadrangular cartilage of the nasal septum is also removed, but will be refashioned and re-implanted into the patient as an autologous batten graft. This will be performed together with standard septoplasty and turbinate reduction.

Group Type EXPERIMENTAL

Batten batten graft

Intervention Type PROCEDURE

The batten grafts are autologous grafts from the patients' own tissue, produced from nasal septal quadrangular cartilage. This will be obtained during the septoplasty portion of the procedure. The batten graft will be used to stabilize the internal nasal valve and prevent nasal valve collapse on inspiration.

Septoplasty

Intervention Type PROCEDURE

A portion of the quadrangular cartilage of the nasal septum is removed. This will be performed as a standard septoplasty.

Inferior Turbinate Reduction

Intervention Type PROCEDURE

The bilateral inferior turbinates will be surgically ablated.

Septoplasty and inferior turbinate reduction alone

In the control arm, a portion of the quadrangular cartilage of the nasal septum is removed. This will be performed as a standard septoplasty and turbinate reduction.

Group Type ACTIVE_COMPARATOR

Septoplasty

Intervention Type PROCEDURE

A portion of the quadrangular cartilage of the nasal septum is removed. This will be performed as a standard septoplasty.

Inferior Turbinate Reduction

Intervention Type PROCEDURE

The bilateral inferior turbinates will be surgically ablated.

Interventions

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Batten batten graft

The batten grafts are autologous grafts from the patients' own tissue, produced from nasal septal quadrangular cartilage. This will be obtained during the septoplasty portion of the procedure. The batten graft will be used to stabilize the internal nasal valve and prevent nasal valve collapse on inspiration.

Intervention Type PROCEDURE

Septoplasty

A portion of the quadrangular cartilage of the nasal septum is removed. This will be performed as a standard septoplasty.

Intervention Type PROCEDURE

Inferior Turbinate Reduction

The bilateral inferior turbinates will be surgically ablated.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients should satisfy all the following criteria to be considered eligible for randomization:

1. Be age 18 or above
2. Able to provide written informed consent
3. Have an indication for batten graft, septoplasty and turbinate reduction according to prevailing surgical practices.

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1. Septal deviation must be present on direct or endoscopic examination
2. Inferior turbinate hypertrophy must be present, direct examination or endoscopic examination
3. Collapse of external nasal valve and/or lateral motion instability must be documented

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1. The ENV maye be assessed clinically by observing the alar collapse at baseline or with forced inspiration, Modified cottle may also be performed.

In all patients, endoscopic examination should document that the (a) septal deviation, (b) turbinate hypertrophy, and (c) external nasal valve collapse are the primary contributing factors of obstructed breathing.

Exclusion Criteria

1. Septal perforation
2. History of previous functional rhinoplasty or sinus or septal surgery
3. Patients who are selected for concurrent aesthetic/cosmetic rhinoplasty
4. Untreated allergic rhinitis or allergic rhinitis unresponsive to medical management
5. Patients who have concurrent sinus surgery or polyp removal or concha bullosa resection
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Northwell Health

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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David Hiltzik, MD

Role: PRINCIPAL_INVESTIGATOR

Northwell Health

Locations

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Poplar Bluff Regional Medical Center

Poplar Bluff, Missouri, United States

Site Status NOT_YET_RECRUITING

Lenox Hill Hospital/Staten Island University Hospital

New York, New York, United States

Site Status RECRUITING

Staten Island University Hospital

Staten Island, New York, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Research Department

Role: CONTACT

718-226-6256

David Hiltzik, MD

Role: CONTACT

212-434-4500

Facility Contacts

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Alexandros Georgolios, MD, FACS

Role: primary

573-778-2600

McKenna Hawthorne

Role: backup

573-778-2600

David Hiltzik, MD

Role: primary

718-226-6110

David Hiltzik, MD

Role: primary

718-226-6110

Shannen Belotte, MBA

Role: backup

718-226-8559

Other Identifiers

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21-0204

Identifier Type: -

Identifier Source: org_study_id

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