Nasal Valve Reconstruction Using a Titanium Implant: An Outcomes Study

Abstract

Septoplasty alone is not always sufficient to correct nasal obstruction. Various techniques have been employed to repair nasal valve collapse and improve airflow. This article aimed to evaluate outcomes and quality of life following nasal valve reconstruction using a titanium implant in patients with nasal valve collapse. This is a single-center retrospective study that consisted of a telephone questionnaire of 37 quality-of-life measures and questions related to the surgical procedure and recovery process to evaluate postsurgical outcomes. Fifteen patients completed the survey. There was a significant improvement in nasal blockage/obstruction, breathing through the nose, sleeping, breathing through nose during exercise, the need to blow nose, sneezing, facial pain/pressure, fatigue, productivity, and restlessness/irritability after surgery. Overall, 100% of patients were satisfied with the results and would recommend this procedure. The most common postoperative complaints were pain (33%) and difficulty breathing (33%). Patients noticed no increase (20%) or a slight increase (73%) in the size of their nose. Sixty percent of patients cannot see the implant and 13% report the implant is barely noticeable. Nasal valve repair with a titanium implant was successful at improving symptoms of nasal obstruction and other quality-of-life issues. Satisfaction was high among all patients. The implants are palpable, thought to be visible by some patients, yet accepted by the majority of patients. This approach may be especially important in patients with prior nasal surgery but continue to experience refractory symptoms.

A prospective, non-randomized evaluation of a novel low energy radiofrequency treatment for nasal obstruction and snoring

“…The significant improvement of patients’ Quality of Life as show for both the SNOT-20-GAV and EQ-5D questionnaires is not unexpected for an effective technique to improve nasal breathing. Patients with problems with nasal breathing have numerous other problems such as the need to blow the nose, sneezing, facial pain, loss of productivity, sleep disturbance, snoring, restlessness and other issues which lead to a decreased quality of life [ 3 , 30 ]. Improvement in one or more of these areas can be expected to be reflected in a QoL questionnaire.…”

“…Even so, a combined septoplasty with turbinate reduction does not always provide a complete solution to the problem. The most frequent cause of septoplasty failure is closely related to the nasal valve [ 3 ].…”

Management of Lateral Wall Insufficiency

“…Titanium, silicone, and porous polyethylene have all been described as alternatives to cartilage grafting in rhinoplasty. [18][19][20][21] Latera (Stryker, Kalamazoo, MI) is a Food and Drug Administration-approved bioabsorbable implant comprised of a 70:30 blend of poly(L-lactide) and poly(Dlactide) that is designed to support the ULC and LLC (see ►Fig. 1).…”

Promising Implants in Rhinoplasty

“…Titanium implants are used in nasal valve reconstruction to provide improved cosmesis and functional outcomes compared with cartilage grafts, as they have a lower profile with better structural support than cartilage. 38 Titanium implants tent the upper lateral cartilages open to improve the internal nasal valve. Although cartilage butterfly grafts have been found to be effective for widening and strengthening the nasal valve, this graft can lose elasticity and strength over time, create fullness in the cartilaginous nasal dorsum, and has the inability for graft adjustment later.…”

“…E. West Chester, PA 19380) titanium plates off-label for nasal valve reconstruction, there was a 12% incidence (2/16 patients) of plate extrusion at the marginal incision. 38 One patient's titanium plate broke postoperatively and one patient had a plate infection. Although titanium implants have been developed to mitigate the limitations of cartilage grafts and multiple studies have shown their independent effectiveness, there are no studies that directly compare titanium implants with cartilage grafts.…”