The Impact of Bioabsorbable Nasal Implants, Nasal Radiofrequency Remodeling, and Anesthesia Type on Patient Selection for Nasal Valve Surgery

Objective: To compare patient demographics, comorbidities, anesthesia type, and trends in nasal valve implantation (NVI) and nasal radiofrequency remodeling (NRR) techniques versus traditional nasal valve repair (NVR). Study Design: Retrospective case-control. Setting: In total, 58 health care organizations (HCOs) across the United States. Methods: The TriNetX Research Network was queried from 2021 through 2023, forming three cohorts of patients who underwent (1) NVR, (2) NVI, or (3) NRR. Demographics, comorbidities, and anesthesia type were compared across groups at the time of intervention. Results: A total of 10,568 NVR, 764 NVI, and 485 NRR cases were identified. Patients undergoing NVI or NRR compared to NVR were more likely to be older and exhibit a higher prevalence of medical comorbidities, including sleep apnea, hyperlipidemia, type 2 diabetes, gastroesophageal reflux disease, liver disease, hypertension, ischemic heart disease, other heart diseases, cerebrovascular disease, hearing loss, and kidney disease (all P <.05). Of all cases, 82.4% of NVR, 84.8% of NVI, and 55.2% of NRR were performed under general anesthesia. Patients who underwent NRR had the highest comorbidity burden of all cohorts and were most likely to receive local anesthesia. However, when analyzing anesthesia type by specific procedure (NVR, NVI, and NRR), most comorbidities were not significantly more common in those who underwent local anesthesia compared to general anesthesia. Conclusion: NVI and NRR have provided surgeons with alternative treatment options for nasal valve collapse, especially for patients who are older and with a higher burden of medical comorbidities.