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Nasal FractureNCT04038645

Evaluation of Photobiomodulation on Nasal Fractures

A study testing Experimental group (laser) in people with Nasal Fracture, run by University of Nove de Julho.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

Nasal fractures are one of the most incidental of facial traumas. Regression of nasal edema is necessary so that surgical reduction of the fracture can be performed. It is known that photobiomodulation (PBM) reduces pain, edema and modulates inflammation. Read more about this study

Who is it for?
Ages 18 to 60 yearsHealthy volunteers can take part
Conditions the study is for
Nasal Fracture
What is being tested?
Experimental group (laser)
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
0 participants
Where
No sites listed yet
Study dates
1 Dec 2019to 15 Oct 2020
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 60 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • healthy participants.
  • With a maximum of 48 hours after nasal trauma.

Who cannot join

  • Patients using anticoagulant medication or use of medication that is anti-inflammatory chronically .
  • Patients who report a hypersensitivity reaction to any drug used in the research
  • Patients with previous nasal fractures.

About this study

Official title: Evaluation of Photobiomodulation on Nasal Fractures: a Randomized, Controlled, Double-blind Clinical Study

Nasal fractures are one of the most incidental of facial traumas. Regression of nasal edema is necessary so that surgical reduction of the fracture can be performed. It is known that photobiomodulation (PBM) reduces pain, edema and modulates inflammation. Regression of edema in a shorter time may decrease hospitalization time, decreasing hospital costs. However, there are no well-designed clinical studies on this subject. Therefore, the objective of this study will be to evaluate if PBM is able to reduce edema in the region of fractured nasal bones prior to nasal reduction and nasal packing, in order to reduce the patient's ability to go through surgery. Thirty-six patients diagnosed with a (primary) nasal fracture admitted to the Mandaqui Hospital Complex whose trauma occurred in the last 48 hours will be randomly divided into: G1- (control) (n = 18). . G2-Light emitter diode (LED) group (n = 18) - The standard hospital treatment will be performed + LED nasal mask. The main variable will be the edema evaluated by the same researcher and with the same technique. Secondary variables will be pain (visual analogue scale - VAS), temperature, rescue medication count, serum C-reactive protein and systemic inflammatory cytokines. Afterwards, the LED or its placebo will also be applied. The questionnaire to assess the impact of treatment on quality of life will be applied at the baseline and after 8 days. Adverse effects will be recorded and reported. If the data is normal, they will be submitted to Student's t-test. The data will be presented by their means ± standard deviation (SD) and the value of p will be set at 0.05.

Read the detailed description

Nasal fractures are one of the most incidental of facial traumas. Regression of nasal edema is necessary so that surgical reduction of the fracture can be performed. It is known that photobiomodulation (PBM) reduces pain, edema and modulates inflammation. Regression of edema in a shorter time may decrease hospitalization time, decreasing hospital costs. However, there are no well-designed clinical studies on this subject. Therefore, the objective of this study will be to evaluate if PBM is able to reduce edema in the region of fractured nasal bones prior to nasal reduction and nasal packing, in order to reduce the patient's ability to go through surgery. Thirty-six patients diagnosed with a (primary) nasal fracture admitted to the Mandaqui Hospital Complex whose trauma occurred in the last 48 hours will be randomly divided into: G1- (control) (n = 18). The control group will be submitted to the standard hospital treatment: standard drug therapy (50mg diclofenac sodium - 5 days, 8 / 8h orally and 500mg dipyrone - 5 days, 6 / 6h , orally). Tylex 30mg orally will be given as rescue medication. In this group there will be simulation of the use of the mask. G2- LED group (n = 18) - The standard hospital treatment will be performed + LED nasal mask (3 points on each side of the nose), λ = 830nm, radiant exposure of 9.7 Joules J / cm2 for 10 minutes. Treatment will be performed at patient admission (up to 24 hours after nasal trauma), and at intervals explained below, for approximately 08 days after hospital admission. The main variable will be the edema evaluated by the same researcher and with the same technique. Secondary variables will be pain (visual analogue scale - VAS), temperature, rescue medication count, serum C-reactive protein and systemic inflammatory cytokines (TNF-α, interleukin-1 (IL-1), IL-6, IL-8 and IL- nasal fossa and saliva. All evaluations will be performed at baseline (T0) up to 48 hours after trauma, aiming at equivalence in the inflammatory process, (T1) 96h after trauma and (T2) 192h after trauma. Afterwards, the LED or its placebo will also be applied. The questionnaire to assess the impact of treatment on quality of life will be applied at the baseline and after 8 days. Adverse effects will be recorded and reported. If the data is normal, they will be submitted to Student's t-test. The data will be presented by their means ± SD and the value of p will be set at 0.05.

Conditions
Nasal Fracture
Being tested
Experimental group (laser), Control group (Placebo)
Keywords
Nasal Fracture, Photobiomodulation, Laser, Edema
Medical subject headings
Edema

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Experimental group (laser)Other

    The patients will receive infrared LEDs in 6 points using a mask developed for the research . The irradiations will be performed with red LED ( wavelength = 660 nm) with output power of 100 milliwatt. During application of the LED both patient and operator will wear goggles.

    The red diode laser will be used. The power of the device is 100 mW and the wavelength used was 660nm (± 10nm). The diameter of the fiber optic of the apparatus has 600 μm, therefore a spot (area) of 0.002826cm2. The energy delivered per point is 1 Joule. 10 seconds of application is required. As 6 points are irradiated, the total energy delivered is 6 Joules. The energy density is 354 J / cm2 and the power density would be 35.4 W / cm2. The points will be determined by the same operator, obeying the protocol.

  • Control group (Placebo)Other

    Patients will receive the LED at the same points recommended for the experimental group, but will be off. So that the patient does not identify the sound of activation of the device (beep), it will be recorded, and connected at the time of the application of the laser. The questionnaire to assess the impact of treatment on quality of life will be applied at baseline and after 8 days as well as the evaluation of serum CRP.

Study groups in NCT04038645
Study groupRoleWhat they receive
Experimental Group (laser)Active comparatorThe patients (n=18) will receive infrared LEDs in 6 points (3 on the right side and 3 on the left side) using a mask developed for the research . The irradiations will be performed with red LED ( wavelength = 660 nm) with output power of 100 milliwatt (mW) . The LED light outputs will be positioned in direct contact with the skin. During application of the LED both patient and operator will wear goggles. The red diode laser will be used. The power of the device is 100 mW and the wavelength used was 660nm (± 10nm). The diameter of the fiber optic of the apparatus has 600 μm, therefore a spot (area) of 0.002826cm2. The energy delivered per point is 1 Joule. 10 seconds of application is required. As 6 points are irradiated, the total energy delivered is 6 Joules. The energy density is 354 J / cm2 and the power density would be 35.4 W / cm2. The points will be determined by the same operator, obeying the protocol.
Receives: Other: Experimental group (laser)
Control group (Placebo)Placebo comparatorThe patients (n=18) will receive the LED at the same points recommended for the experimental group, but will be off. So that the patient does not identify the sound of activation of the device (beep), it will be recorded, and connected at the time of the application of the laser. The questionnaire to assess the impact of treatment on quality of life will be applied at baseline and after 8 days (by the same evaluator), as well as the evaluation of serum CRP.
Receives: Other: Control group (Placebo)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Edema

    It will be applied a grading system for evaluating eyelid edema: 0 point, none; 1 point, minimal; 2 points, extending on to the iris; 3 points, covering the iris; 4 points, massive edema with the eyelid swollen shut.

    Measured: Throughout study completion on average of one year

Secondary outcomes (8)
  1. pain assessed by Vas

    The pain will be assessed by applying a VAS visual analogic scale, consisting of a 100-mm line numbered in centimeters, with two closed ends. One end is labeled "0" and the other "100", meaning no pain and terrible pain, respectively. Each patient will be instructed to mark a vertical line with the point that best matches the intensity of pain during the evaluation. Instructions on marking will always be given to the patient by the same operator

    Measured: Throughout study completion on average of one year

  2. Oral health related quality of life (OHRQoL) assessed by ohip-14

    Oral health related quality of life: using Oral Health Impact Profile (OHIP-14)questionnaire we will assess the impact on HRQOL will be measured. This instrument consists of 14 items arranged in 7 factors: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap. The answers are given in a 5-point Likert scale (0 = never, 1 = rarely, 2 = sometimes, 3 = often, 4 = always).

    Measured: Throughout study completion on average of one year

  3. C-reactive protein (CRP)

    After approximately 4 to 24 hours of trauma, CRP serum levels reach peaks up to 1000 times its initial concentration, although it is a nonspecific marker and is closely related to tissue necrosis and inflammatory processes. The collection of 10 ml of peripheral blood will be performed through a specific tube by the nurses of the Mandaqui Hospital Group. This analysis will be performed at baseline and on the last assessment day.

    Measured: Throughout study completion on average of one year

  4. temperature

    Temperature will be measured locally and systemically. The local measurement was measured using a Safety 1st® digital thermometer (Safety 1st®, "No Touch Forehead", Columbus, USA) in the nasal dorsum, one centimeter below the glabella.

    Measured: Throughout study completion on average of one year.

  5. Nasal Obstruction

    Nasal Obstruction - To evaluate nose permeability the following methodology will be used, the patient will be asked to numerically choose their sense of obstruction on a scale from zero to ten, zero represents no obstruction of air passage and ten indicates total obstruction. During evaluations the patient will not be allowed to see previous ratings. The patient should point out two numbers indicating that the score will be at an intermediate value. The result will be the average of both values. The value obtained will be multiplied by 10, for ease of comparison.

    Measured: Throughout study completion on average of one year.

  6. Bruise

    Periorbital bruise will be assessed in each patient by assessing the upper and lower eyelids separately, using a 0 to 4-point scale, Kargi scale, 2003

    Measured: Throughout study completion on average of one year.

  7. Salivary cytokines TNF-α, interleukin-1 (IL-1), IL-6, IL-8 and IL-10

    5 ml of saliva sample will be collected in 50 ml tubes. They will be aliquoted (1.2ml) into 2 sterile microtubes and the samples will be stored at -80 ºC until further analysis of cytokines TNF-α, interleukin-1 (IL-1), IL-6, IL-8 and IL-10 via ELISA.

    Measured: Throughout study completion on average of one year.

  8. nasal exudate cytokines TNF-α, interleukin-1 (IL-1), IL-6, IL-8 and IL-10

    Exudate samples will be collected with a paper cone that will be placed in the nasal cavity until resistance is felt. The cones will be placed in one sterile microcentrifuge tube and stored at -80 Celsius degree (ºC) until further analysis of cytokines TNF-α, interleukin-1 (IL-1), IL-6, IL-8 and IL-10 via ELISA.

    Measured: Throughout study completion on average of one year.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted31 Jul 2019
  2. Study start1 Dec 2019 (estimated)
  3. Primary completion30 Dec 2019 (estimated)
  4. Study completion15 Oct 2020 (estimated)

Why it stopped: Researcher will no longer conduct the study

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
36 patients will be allocated in the experimental and control groups: G1 - Experimental Group (n = 18 Photobiomodulation PBM) - the treatment will be performed in a conventional manner and the patient will receive laser at low intensity. G2 - Control group (n = 18 -placebo of PBM) - treatment will be performed in a conventional manner and simulation of PBM treatment.
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04038645
Sponsor's protocol ID
Nasal fracture
Status last verified
Dec 2019
First submitted
25 Jul 2019
Last updated
29 Jun 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Kargi E, Hosnuter M, Babuccu O, Altunkaya H, Altinyazar C. Effect of steroids on edema, ecchymosis, and intraoperative bleeding in rhinoplasty. Ann Plast Surg. 2003 Dec;51(6):570-4. doi: 10.1097/01.sap.0000095652.35806.c5.

    PubMed 14646651
  • Oliveira Sierra S, Melo Deana A, Mesquita Ferrari RA, Maia Albarello P, Bussadori SK, Santos Fernandes KP. Effect of low-level laser therapy on the post-surgical inflammatory process after third molar removal: study protocol for a double-blind randomized controlled trial. Trials. 2013 Nov 6;14:373. doi: 10.1186/1745-6215-14-373.

    PubMed 24195796

Questions about this trial

What is this clinical trial studying?

A study testing Experimental group (laser) in people with Nasal Fracture, run by University of Nove de Julho.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: withdrawn, as of the sponsor's last update on 29 Jun 2023. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was withdrawn before enrolling participants, so there are no results.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Edema (time frame: Throughout study completion on average of one year). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04038645, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Jun 2023.

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