What is Insertion of Nasal Septal Prosthesis: Overview, Benefits, and Expected Results

Definition & Overview

A nasal septal prosthesis, also called a nasal septal button, is a device used to close a perforation (hole) in the nasal septum; a condition referred to as a nasal septal perforation (NSP). The prosthesis can be made out of acrylic, plastic, or silicone.

The nasal septum is the cartilage that separates the left and right nostrils. A hole in the septum may, or may not, produce a variety of symptoms. NSPs that do not produce any symptoms usually don’t require any treatment.

NSPs that produce symptoms can be treated conservatively, which involves the use of humidifiers or skin moisturisers to reduce the symptoms. However, if the method fails, the surgical closure of the perforation could be required.

Unfortunately, closing the hole in the septum through surgical means is a complicated task. In fact, there are only a few surgeons who specialise in this particular procedure. There is also a possibility that the surgery may not be a success. A viable alternative to surgery is to insert a nasal septal prosthesis in the hole to close it.

An insertion of a nasal septal prosthesis is much less complicated. The procedure can be done in a doctor’s office. However, like any other medical procedure, inserting a septal prosthesis has associated risks and can result in complications.

Who Should Undergo & Expected Results

As mentioned earlier, the candidates for an insertion of a nasal septal prosthesis are patients with a perforation in the nasal septum that results in one or more symptoms. The most common symptoms of an NSP include:

• Breathing difficulty
• Nosebleed
• Excessive mucus production resulting in a runny nose
• A whistling sound while breathing through the nose
• Infection
• Dryness of the nasal septum resulting in crusting
• Pain

If the insertion of the prosthesis is successful, patients can expect a significant reduction of the symptoms. Unfortunately, not all procedures can be deemed a success. If the procedure fails, the ENT doctor may need to replace the prosthesis or recommend a surgical closure of the perforation instead.

How Does the Procedure Work?

Several techniques can be used to perform this procedure. The particular technique an ENT doctor may opt to use will depend on his or her expertise in that technique, the type of prosthesis to be used, and the condition of the perforation.

There are several different types of nasal septal prostheses. The traditional types are one or two-piece devices. The prosthesis is made up of two circular shaped flanges connected by a tube in the centre. The concept of the procedure is to insert the prosthesis in the septal perforation. The flanges will then close the hole. If successful, the symptoms of the condition should be reduced almost immediately. Prior to the procedure, the doctor will first clean the nasal cavity to remove mucus or any obstructions, such as crusting. The doctor will then apply a local anaesthetic so the patient will not feel any pain throughout the procedure.

Using a paper, special marking pen, and ruler, the doctor will measure the perforation so that the right size prosthesis can be used. Using the wrong size can result in the failure of the procedure. Once the right prosthesis has been selected, the doctor will roll the flanges into a tube shape and insert the device into the narrower nostril. One flange is inserted into the hole so that it can be moved into the wider nostril.

The doctor will then carefully pull the rest of the flange through the hole and move the device a bit so it fits snuggly and effectively covers the hole.

After the procedure, the patient will be instructed to clean the nasal cavity at least three times a day using saline solution. Once the area is cleaned thoroughly, nasal cream will be applied to prevent it from drying up and causing problems. The patient may also be instructed to perform steam inhalation for about two weeks.

The patient will need to use the prosthesis for as long as the perforation in the septum is present. This could mean a lifetime. However, there might come a time wherein the prosthesis will need to be replaced. This time will depend on the patient’s willingness and dedication in cleaning the nasal cavity. Some patients don’t require a replacement until well over a year the prosthesis has been in place.

Possible Risks and Complications

Patients should be aware of the possibility that the nasal prosthesis may not fit or adjust to the nasal cavity properly. If this happens, the device may not only feel uncomfortable, but may also result in excessive tearing in the eyes and/or a runny nose. In some cases, the device may cause the patient to sneeze repeatedly.

If the prosthesis is made of soft silicone, there is also the possibility that the tip of the flanges may bend while breathing forcefully. This could result in the tip blocking the nasal cavity making it difficult to breathe from time to time.

A failed nasal septal prosthesis insertion means that the device needs to be replaced. The doctor may need to select a different size or a device that can be customised to the patient’s needs. Surgery to close the perforation can also be recommended.

References: * M Mullace, E Gorini, M Sbrocca, L Artesi, N Mevio; “Management of nasal septal perforation using nasal septal button”; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2639999/

• Belachew Tessema; “Nasal Septal Button Placement”; http://emedicine.medscape.com/article/1580556-overview?pa=tzROFhc1hcJcCjaijWRaEFPawVn8Ojp1qcxOOGAu9dTlJSY5GQygMK3qiTI%2Fl7AtihS5yMijIYstO%2BztpGLUGCchrzF%2F7vlnSF6AEX%2F09M8%3D#a7

• Thomas Romo III MD, FACS; “Septal Perforation – Surgical Aspects Treatment & Management”; http://emedicine.medscape.com/article/878817-treatment#d11

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Question:⁣ What ⁤is Insertion of Nasal Septal Prosthesis?



Answer: Insertion of a nasal‌ septal prosthesis is a surgical procedure that involves the insertion of a small artificial device into the nasal septum to correct a deviated septum or to provide structural support to the nose. It is commonly⁤ performed to improve airflow and​ alleviate ⁤breathing difficulties caused by a septal ‌deviation.



Benefits of Nasal Septal Prosthesis Insertion:



1. Improved Airflow: By correcting a deviated septum, the prosthesis can improve nasal airflow, reducing‌ nasal congestion and easing breathing difficulties.



2. Reduced Obstruction: The prosthesis can relieve nasal obstruction caused by a septal​ deviation, allowing for ‌better‌ passage‍ of air during breathing.



3. Enhanced Sinusitis Management: A ⁢septal prosthesis can facilitate sinus drainage by improving airflow‌ in the nasal passages, potentially reducing the incidence and severity ‍of sinusitis infections.



4. Improved Nasal ⁤Aesthetics: In some cases, insertion of a septal prosthesis⁢ can lead to improved nasal aesthetics, resulting in a more balanced and aesthetically pleasing facial⁤ profile.



5.⁣ Reduced Nosebleeds: By correcting the septal deviation and ⁢providing structural ⁣support,‍ the prosthesis ‍can reduce the risk of ​nosebleeds caused by septal contact with the nasal mucosa.



Expected Results from Nasal Septal Prosthesis Insertion:



1. Improved Breathing: Patients ​often report improved breathing and reduced nasal congestion after the procedure, leading to better overall respiratory function.



2. Reduced Sinus Infections: By facilitating sinus⁣ drainage, the prosthesis can reduce the frequency and severity of‌ sinus infections, improving overall sinus health.



3. Enhanced Sleep​ Quality: Improved ⁢nasal airflow and reduced congestion can contribute to better sleep quality, reducing the risk of sleep disturbances or conditions like⁢ sleep apnea.



4. Improved Appearance: In cases where nasal aesthetics is a concern, the prosthesis can result in a⁤ more symmetrical and balanced facial profile, enhancing ⁣the appearance of the nose.



5. Sustained Benefits: The results of septal prosthesis insertion are generally long-lasting, providing ongoing improvements in nasal airflow and breathing over the long term.



It‌ is important to note ⁢that the insertion of a nasal septal prosthesis is not without risks and potential complications. Patients should discuss ⁣the potential risks and benefits of the procedure with their ‌healthcare provider before making a⁢ decision.