ENT has said I have long term nasal inflammation causing internal valve collapse. Surgery or implant?

Question

Is surgery or implant better option. It is very hard breathing currently. Huge improvement wearing breathe right strips - even voice is less raspy and clearer. An implant like Latera seems less invasive but risk of infection and feeling of foreign body in nose. Surgeon has told me surgery (using septal grafts to support cartilage) is not always successful and carries risks of nerve damage, dryness. Can you suggest which option might be better?

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  With that
being said, based on your description, a spreader graft consisting of septal cartilage placed at the junction of your internal nasal valve is the best option by far.  This surgery has an extremely high success rate in the right patient.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Reza Momeni, MD, FACS · Answer

In my experience spreader grafts for internal valve collapse are the gold standard for repair in most patients, but you'll have to have an in person evaluation to know what exactly is best for you.

William Portuese, MD · Answer

A thorough  examination of the internal and external portion of the nose is required to make a determination about a surgical procedure versus medical management. In addition, it's important to discern if there's static or dynamic collapse or vestibular stenosis. Spreader graft placement is  one type of cartilage graft that can be used to help with this issue. For more information, please see the video below

Fred J. Bressler, MD, FACS · Answer

Thanks for your post. By far the best option with regard to correction for external alar valve collapse or internal upper lateral cartilage collapse is with nasal septal cartilage from your own nose via a repair vestibular stenosis procedure. This option can be performed either via an open or closed approach, under general anesthesia on an outpatient basis. This option offer a high degree of success with few risks in the hands of an experienced surgeon. I would avoid insertion of foreign body for nasal valves, when standard cartilage repair is so beneficial. You may want to consult with a surgeon who regularly performs valve repair for a second opinion. I am not aware of any significant nerve damage or dryness risks associated with nasal valve repair using cartilage. Best wishes.

Michael Carlisle, MD - Account Suspended · Answer

Rhinoplasty with spreader graft is the best option. I perform this operation multiple times per week and it is 95-99% effective in the right patients...those who have true internal nasal valve collapse. Implants and foreign bodies always carry a risk of extrusion. Of course, this is only an opinion. I'm sure you will find a few surgeons who use it frequently with success. But cartilage is the standard. Implant when there is nothing else available for grafting (like septal or ear cartilage).

ENT has said I have long term nasal inflammation causing internal valve collapse. Surgery or implant?

Answers (5)

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