Author(s)
Sai P. Reddy
Jordan Kai Simmons
Wasiq Nadeem
Henry H. Chen
Matthew K. Lee
Affiliation(s)
Temple University Lewis Katz School of Medicine;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to 1) recognize myofunctional therapy, including specific modalities such as biofeedback training, nasal muscle exercises, and electrostimulation, as a potential treatment for nasal valve insufficiency; 2) appreciate differences in subjective versus objective improvements in nasal valve function; and 3) evaluate the potential of biofeedback therapy as a potential option for noninvasive management as opposed to the prevailing surgical treatments for nasal valve insufficiency.
Objectives: Surgical correction continues to be the mainstay of treatment for nasal valve insufficiency. This systematic review explores the efficacy of myofunctional therapies, including biofeedback training, nasal muscle exercises, and electrostimulation, in treating nasal valve insufficiency.
Study Design: Systematic review.
Methods: We conducted a literature search and identified four studies published between 2004 and 2022 that met our inclusion criteria. The included literature examined biofeedback training, nasal muscle exercises, and electrostimulation therapies as options for myofunctional therapy. The primary outcomes were measured through subjective and objective improvement in nasal valve obstruction and assessed through the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS), rhinomanometry, acoustic rhinometry, and electromyography (EMG).
Results: Biofeedback training with nasal muscle exercises consistently showed both subjective and objective improvement in nasal valve function. Electrostimulation resulted in initial improvement but failed to offer long term benefits. Nasal muscle exercises as a standalone treatment were not found to provide significant subjective improvement on the SCHNOS-O scale. Notably, the addition of electrostimulation to therapy with biofeedback and muscle exercises did not significantly improve nasal valve obstruction.
Conclusions: Preliminary evidence suggests that biofeedback therapy offers a promising noninvasive option for the treatment of nasal valve insufficiency. Gaps in the literature underscore the need for further research to determine the specific role of NMF therapy in treatment, identify the most optimal method, and understand long term outcomes.