Related Experiment Video
Updated: May 19, 2026
Reduced Procedure Time and Variability with Active Esophageal Cooling During Radiofrequency Ablation for Atrial Fibrillation
Published on: August 25, 2022
Pooled Analysis of Sleep Outcomes After Treatment With Temperature-Controlled Radiofrequency in Nasal Airway
Masayoshi Takashima1, Ashwin Ananth2, Paul T Hoff3,4
1Department of Otolaryngology-Head & Neck Surgery Houston Methodist Hospital Houston Texas USA.
Objective:
To assess the long-term impact of temperature-controlled radiofrequency (TCRF) treatment on sleep-related symptoms in patients with nasal airway obstruction (NAO), including those with documented obstructive sleep apnea (OSA).
Study Design:
Pooled analysis of prospective multicenter studies.
Setting:
Seven academic and 25 private otolaryngology sites.
Methods:
A pooled analysis of 345 adults across four prospective multicenter studies (PIVOTAL, VATRAC, SWELL, and AERWAY) from 7 academic and 25 private otolaryngology sites was conducted. Participants had severe-to-extreme NAO and received a single, office-based TCRF treatment targeting the nasal valve or septal swell body (SSB). Outcomes included sleep-related components of the Nasal Obstruction Symptom Evaluation (NOSE) scale, 22-item Sino-Nasal Outcome Test (SNOT-22) sleep domain, and Epworth Sleepiness Scale (ESS). Analyses included stratification by the presence or absence of OSA and linear regression.
Results:
TCRF treatment was associated with significant, durable improvements in sleep-related symptoms through 24 months. At 24 months, the "Trouble Sleeping" subcomponent of the NOSE score improved by -1.9 (95% CI, -2.0 to -1.7) points, a 64% improvement. SNOT-22 sleep domain scores declined by -9.0 (95% CI, -10.5 to -7.6) points, with more than 80% of participants achieving clinical improvement. Among those with excessive daytime sleepiness (ESS ≥ 10), ESS dropped by -8.3 (95% CI, -9.7 to -6.9), and the prevalence of sleepiness fell from 53.8% to 9.8%. Improvements were consistent across the OSA+ subgroup.
Conclusion:
Office-based TCRF therapy targeting the nasal valve and/or SSB is associated with clinically meaningful, durable improvements in sleep-related symptoms and daytime somnolence in NAO patients, including a subset of those with documented OSA.
