How do lateral spirox implants compare to spreader graft in correcting an internal valve collapse?

Thank you for your question on this complex topic. In short, Spirox implants mainly improve external nasal valve collapse. However, this is temporary as the implant is resorbable and dissolves over time. Some physicians believe that the results are long-lasting, though, due to scar tissue formation. The advantage of the Spirox implant is that it may be placed in the office under local anesthesia and is a relatively simple procedure. The disadvantage is that it does not provide a long-term relief to nasal obstruction. It also is a foreign body and has hence the risks that are inherent to any foreign body, meaning infection and extrusion. An alternative to the Spirox implant is placement of alar batten grafts (not spreader grafts as those mainly address internal nasal valve collapse) utilizing ones own cartilage. The benefits are lifelong improvement and a much lower risk of infection. The disadvantage is that it is a surgical procedure that requires anesthesia. However, a septoplasty is often required anyway and the alar batten grafts can easily be placed during the same procedure utilizing the septal cartilage that was harvested as part of the septoplasty. Breathe right strips do work in many patients but are visible and can lead to skin irritation. Nasal obstruction is a multifactorial problem and each factor should be addressed. Hope this helps. 

The latera implant may do a great job at correcting nasal valve (internal and external) collapse in some patients.  I have been very impressed in several patients, and have seen mediocre results in some patients as well.  However, the same can sometimes apply to rhinoplasty that some results are more powerful than others.  The real advantage of a latera implant is that it can be performed as a minimally invasive procedure, either standalone in the office setting, or with other nasal surgery such as a septoplasty and inferior turbinate submucous resection.  This avoids some of the downtime, and visible swelling and recovery that invariably comes along with a rhinoplasty surgery.  That being said, I still offer open rhinoplasty (with appropriate graft eg spreader, alar batten, lateral crural strut graft) as the "gold standard" and best choice for most patients.  If the patient is willing to undergo the more advanced procedure with longer recovery period, likely the results will be more powerful.  

It is easy to do a nasal valve repair with a proper cartilage graft either used as a batton graft or a spreader graft and lasts forever. It is much better than the Spirox implants.RegardsDr. Janjua

This is a good question, but unfortunately there have been few scientific studies comparing these various treatments for valve collapse. As far as the spirox implants, this is a relatively new and unproven technique which remains to be evaluated for its long term effectiveness and complication rate. We will have to get evidence based results regarding nasal obstruction after the insertion of these allografts. The use of spreader grafts in internal valve obstruction has value in some patients depending on the severity of the collapse. But often one sees little subjective improvement in the breathing. The effects of using spreader grafts in the presence of cosmetic deformities is far more predictable. The use of breathe right strips however can be fairly dramatic, this is a very inexpensive way to deal with subjective functional breathing obstruction. Best of all it doesn't require a surgical procedure. 

There is no definitive study that compares cartilage spreader grafts and spirox implants for valvular improvement. The only known differences is how and when they are used. If one is having open rhinoplasty surgery anyway then spreader grafts should be done. If not spirox implants can be placed under local anesthesia in the office.

Hello CDP71 - We do not currently have long term data on the spirox implant. Suture fixation of the nasal valve has been around for a long time, however, and has not been shown to last as long as cartilage grafting for the support of nasal grafts. If you translate that data to the new implant, then I would be hesitant to say they are equivalent or last as long. The advantage is ease of administration which may be an advantage for some patients. 

Insertion of lateral spirox implants is a simple office procedure which can be done under local anesthesia.    They are just as efficient as spreader grafts.   Spreader grafts require anesthesia and surgery - the only time I would recommend them over the implants would be if you are having nasal surgery anyway and your nose will be open.