Lugo, R. (Rodolfo)

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    Could the use of a new novel bipolar radiofrequency device (Aerin) improve nasal valve collapse? A systematic review and meta-analysis
    (2023) Lugo, R. (Rodolfo); Pierri, M. (Michelangelo); Jacobowitz, O. (Ofer); Mofa, A. (Antonio); Baptista-Jardin, P. (Peter); Giorgi, L. (Lucrezia); Casale-Falcone, M. (Manuele)
    BackgroundSurgical treatment for nasal obstruction caused by nasal valve collapse requires a significant recovery period and risks of complications, while nasal dilators are uncomfortable. Recently, radiofrequency treatment of lateral walls has been used under local anesthesia as an office base surgery. This work aims to assess the efficacy of a new radiofrequency device, the Vivaer (TM) System (Aerin Medical, Sunnyvale, CA), to treat nasal obstruction through a systematic review and meta-analysis.MethodsTwo researchers independently reviewed the literature up to December 2021. Studies on patients seeking treatment for nasal obstruction due to nasal valve collapse were included in the analysis.ResultsFour studies (218 patients) met the inclusion criteria and treated the nasal valve regions bilaterally with the Aerin Medical Vivaer (TM) System. After the treatment, the NOSE score was reduced at three months postoperatively. Minor adverse events were reported in the included studies, and two showed no complications. None of the studies reported changes in the external appearance of the nose.ConclusionThe radiofrequency treatment using the Vivaer device can be useful for treating nasal valve collapse, improving significantly subjective breathing symptom scores. Further studies on a large scale are needed to confirm these results.
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    Barbed pharyngoplasty for snoring: does it meet the expectations? a systematic review
    (2023) Lugo, R. (Rodolfo); Carnuccio, L. (Luca); Moffa, A. (Antonio); Cassano, M. (Michele); Giorgi, L. (Lucrezia); Baptista, P.M. (Peter M.); Casale-Falcone, M. (Manuele)
    To date, the use of barbed sutures for the surgical management of patients suffering from obstructive sleep apnea and snoring with retropalatal collapse and vibration has significantly increased. A systematic review was carried out, which included clinical studies that used barbed sutures for the treatment of snoring. A qualitative analysis, including six clinical studies, was conducted. Of these, five were studies on barbed pharyngoplasties, and one study involved a minimally invasive surgical procedure. The population consisted of 176 patients, aged 26 to 58 years old. Overall, the included studies showed a mean gain in the snoring Visual Analog Scale of 5.67 +/- 1.88, with a mean preoperative value of 8.35 +/- 1.17 and a postoperative value of 2.68 +/- 1.27. No major complications were described. Given the lack and heterogeneity of this evidence, the conclusion calls for being cautious. In carefully selected snorers and obstructive sleep apnea patients, the use of barbed sutures could represent a valid therapeutic strategy for snoring, ensuring a statistically significant improvement in the subjective parameters. Further studies on a larger scale that assess the role of barbed pharyngoplasties in snoring surgery and more extended follow-up studies are needed in order to confirm these promising results.
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    Comparison of intranasal steroid application using nasal spray and spray-sol to treat allergic rhinitis: a preliminary investigation
    (2023) Lugo, R. (Rodolfo); Carnuccio, L. (Luca); Moffa, A. (Antonio); Baptista-Jardin, P. (Peter); Giorgi, L. (Lucrezia); Casale-Falcone, M. (Manuele)
    Allergic Rhinitis (AR) is a chronic inflammatory disease of sino-nasal mucosa, is IgE-mediated, and affects 10-40% of the global population. This study aimed to compare the efficacy of nasal administration of Beclomethasone Dipropionate (BDP) delivered via Spray-sol with nasal spray in patients suffering from AR. We included 28 AR patients assigned to one of the two following treatments: the Spray-sol group (BDP via Spray-sol) (n = 13) and the spray group (BDP using a common nasal spray) (n = 15). Both treatments were administered twice daily for 4 weeks. A nasal endoscopy evaluation and Total Nasal Symptom Score were performed at baseline and after treatment. The Spray-sol group showed better results than the spray group regarding nasal endoscopy (edema, p < 0.01; irritation, p < 0.01; secretion, p < 0.01) and nasal symptoms (nasal congestion, p < 0.05; rhinorrhea, p < 0.05; sneezing, p < 0.05; and total score, p < 0.05). No side effects were recorded. These data supported the fact that the use of BDP delivered with Spray-sol is more effective than BDP nasal spray in AR patients. Further studies are needed to confirm these encouraging results.
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    Defining epiglottic collapses patterns in obstructive sleep apnea patients: Francia-Lugo classification
    (2023) Lugo, R. (Rodolfo); Di-Giovanni, S. (Simone); Iafrati, F. (Francesco); Moffa, A. (Antonio); Francia, C. (Carlos); Baptista-Jardin, P. (Peter); Giorgi, L. (Lucrezia); Casale-Falcone, M. (Manuele)
    Obstructive Sleep Apnea (OSA) is characterized by repetitive collapse of the upper airway during sleep. Drug-Induced Sleep endoscopy (DISE) is used to identify the collapse site. Among the possible sites of collapse, the epiglottis occurs more frequently than previously described. In this study, we reviewed DISE findings and classified different epiglottic collapse patterns. We found 104 patients (16.4%) with epiglottis collapse (primary 12.5% and secondary 3.9%). We described the following patterns of epiglottis collapse: Anterior-Posterior (AP) collapse with rigid component trapdoor type (48%); AP collapse with lax component floppy type (13.5%); Lateral- Lateral (LL) collapse with omega shape component book type (14.5%); and secondary due to lateral pharyngeal wall or tongue base collapse (24%). The identification of the epiglottic collapse pattern is crucial in decision-making when attempting to ameliorate OSA. These findings in OSA phenotyping could influence the type of treatment chosen.