Non-Surgical Devices for Nasal Obstruction

Abstract

Nasal obstruction is a common presenting complaint in most otolaryngology practices. A reduction of nasal airflow can contribute to exercise intolerance, snoring, obstructive sleep apnea (OSA), and an overall decreased quality of life. When medical management for non-anatomical issues fails to resolve the obstruction, surgeries targeting nasal obstruction—namely septorhinoplasty and/or inferior turbinate reduction are often considered. A frequently overlooked alternative for these patients is the wide array of non-surgical and minimally invasive appliances available to address nasal obstruction. This article attempts to provide a basic overview of these devices, benefits, and limitations, and the evidence supporting their efficacy in alleviating nasal obstruction.

Keywords

nasal obstruction - nasal cone - nasal stent - septorhinoplasty - nasal appliance

Publication History

Accepted Manuscript online:
20 April 2022

Article published online:
06 July 2022

• References

• 1 Schuman TA, Senior BA. Treatment paradigm for nasal airway obstruction. Otolaryngol Clin North Am 2018; 51 (05) 873-882
• 2 Michels DdeS, Rodrigues AdaM, Nakanishi M, Sampaio AL, Venosa AR. Nasal involvement in obstructive sleep apnea syndrome. Int J Otolaryngol 2014; 2014: 717419
• 3 Kao R, Rabbani CC, Ting JY, Shipchandler TZ. In-office functional nasal surgery. Otolaryngol Clin North Am 2019; 52 (03) 485-495
• 4 Zeina AM, El Zeheiry AM, Bahaa El-Din AM. True and average internal nasal valve area in septorhinoplasty: radiological and clinical outcomes. Ann Plast Surg 2020; 84 (05) 487-493
• 5 McNicholas WT. The nose and OSA: variable nasal obstruction may be more important in pathophysiology than fixed obstruction. Eur Respir J 2008; 32 (01) 3-8
• 6 Schönhofer B, Franklin KA, Brünig H, Wehde H, Köhler D. Effect of nasal-valve dilation on obstructive sleep apnea. Chest 2000; 118 (03) 587-590
• 7 Lee J, White WM, Constantinides M. Surgical and nonsurgical treatments of the nasal valves. Otolaryngol Clin North Am 2009; 42 (03) 495-511
• 8 Okuno K, Ono Minagi H, Ikai K. et al. The efficacy of nasal airway stent (Nastent) on obstructive sleep apnoea and prediction of treatment outcomes. J Oral Rehabil 2019; 46 (01) 51-57
• 9 Ward J, Ciesla R, Becker W, Shanga GM. Randomized trials of nasal patency and dermal tolerability with external nasal dilators in healthy volunteers. Allergy Rhinol (Providence) 2018; 9: 2152656718796740
• 10 Raudenbush B. Stenting the nasal airway for maximizing inspiratory airflow: internal max-air nose cones versus external breathe right strip. Am J Rhinol Allergy 2011; 25 (04) 249-251
• 11 Gelardi M, Porro G, Sterlicchio B, Quaranta N, Ciprandi G, Group On Sonoring IS. Internal and external nasal dilatator in patients who snore: a comparison in clinical practice. Acta Biomed 2019; 90 (Suppl. 02) 10
• 12 Camacho M, Malu OO, Kram YA. et al. Nasal dilators (Breathe Right strips and NoZovent) for snoring and OSA: a systematic review and meta-analysis. Pulm Med 2016; 2016: 4841310
• 13 Noss MJ, Ciesla R, Shanga G. Sleep quality and congestion with breathe right nasal strips: two randomized controlled trials. Adv Ther 2019; 36 (08) 1975-1985
• 14 Kumar AR, Guilleminault C, Certal V, Li D, Capasso R, Camacho M. Nasopharyngeal airway stenting devices for obstructive sleep apnoea: a systematic review and meta-analysis. J Laryngol Otol 2015; 129 (01) 2-10
• 15 Ohtsuka K, Baba R, Yamasawa W. et al. The effectiveness of nasal airway stent therapy for the treatment of mild-to-moderate obstructive sleep apnea syndrome. Respiration 2021; 100 (03) 193-200
• 16 Zhang H, Kotecha B. Effect of intranasal stents (AlaxoLito, AlaxoLito Plus and AlaxoLito Xtreme) on the nasal airway: a case report. World J Otorhinolaryngol 2019; 8 (01) 4-11
• 17 Hale | Inhale Exhale Repeat. 2022 Accessed February 16, 2022 at: https://halebreathing.com/
• 18 Barnes ML, Lipworth BJ. Removing nasal valve obstruction in peak nasal inspiratory flow measurement. Ann Allergy Asthma Immunol 2007; 99 (01) 59-60
• 19 Jang TY, Kim YH. Effect of endonasal dilator on nasal airflow and sleep test index on sleep apnea patients. J Rhinol 2019; 26 (01) 8-15
• 20 Kiyohara N, Badger C, Tjoa T, Wong B. A comparison of over-the-counter mechanical nasal dilators: a systematic review. JAMA Facial Plast Surg 2016; 18 (05) 385-389
• 21 Septum N, Material S, Cavity N. et al. US5713833A—Septum nerve stimulator—Google Patents. 2022 Accessed February 16, 2022 at: https://patents.google.com/patent/US5713833A/en
• 22 Lekakis G, Dekimpe E, Steelant B, Hellings PW. Managing nasal valve compromise patients with nasal dilators: objective vs. subjective parameters. Rhinology 2016; 54 (04) 348-354
• 23 Löth S, Petruson B. Improved nasal breathing reduces snoring and morning tiredness. A 6-month follow-up study. Arch Otolaryngol Head Neck Surg 1996; 122 (12) 1337-1340
• 24 Petruson B, Löth S. Five-year compliance with a nostril dilator. Arch Otolaryngol Head Neck Surg 2000; 126 (09) 1168-1169