Clinical evaluation of a novel internal nasal dilation stent for the improvement of nasal breathing

Computational analysis of nasal airflow and its alteration by a nasal dilator

Nasal airflow obstruction correlates with several ailments, such as higher patency, increased friction at the mucosal wall or the so-called Little's area, improper air conditioning, and snoring. Nasal dilators are frequently employed, mainly due to their ease of access and use, combined with their non-permanent and non-surgical nature. Their overall efficacy, however, has not been clearly demonstrated so far, with some studies reporting conflicting outcomes, mainly because being based on subjective evaluations. This study employs Computational Fluid Dynamics simulations to analyze the flow inside a real nose, performs an objective assessment of a nasal dilator's effect in terms of airflow and air conditioning, reporting flow paths, friction levels, heat and water fluxes and detailed temperature and humidity distributions. Coincidentally, the studied nose presents a septal deviation, with one nostril being wider than the other. The tubes of the dilator used in both nostrils are identical, as with any standard commercial dilator. Consequently, the dilator widens one nostril, as intended, but results in an obstruction in the other. This allows simultaneously addressing two situations, the nominal function of the dilator, as well as an off-design case. Results indicate a 24 % increase in nasal patency in the design situation. The effect, however, is limited, as quantified by appropriate measures, such as the flow-generated friction at the nose surfaces and the temperature fluxes. Hence, the effect of such a dilator in nominal conditions is perhaps not as large as might be hoped. In the off-design situation, nasal resistance increases by 62 %, an undesirable effect, illustrating the consequences of using an inappropriate dilator.

Improvement of the aerobic performance in endurance athletes presenting nasal valve compromise with the application of an internal nasal dilator

PURPOSE

We investigated the effects of an internal nasal dilator on nasal airflow and cardio-respiratory capacity in adult endurance athletes, while performing controlled exhaustive physical exercise.

METHODS

Prospective observational study. Participants were 38 adult endurance athletes, 23 with and 15 without nasal valve compromise. Nasal patency was objectively evaluated with anterior rhinomanometry, acoustic rhinometry and peak nasal inspiratory flow (PNIF). Maximum oxygen uptake (VO2max), maximum pulmonary ventilation, time to exhaustion and total time of nasal respiration were recorded during a submaximal treadmill test. Dyspnea intensity and fatigue perception were evaluated using a labeled visual analog scale. All assessments were performed with and without the application of the internal nasal dilator.

RESULTS

All the parameters related to aerobic capacity were significantly reduced in the group of athletes with nasal valve compromise (p. <0.05 for all variables). The internal nasal dilator improved statistically significantly the nasal patency (p. <0.001), VO2max and aerobic performance and self-rating of dyspnea and fatigue (p. <0.05 for all parameters) only in athletes with nasal obstruction. PNIF correlated significantly with VO2max (rho = 0.4, p. <0.05).

CONCLUSIONS

Internal nasal dilation improves nasal patency and aerobic performance during submaximal exercise in adult endurance athletes with nasal obstruction symptoms due to nasal valve compromise.

Displaced nasal dilator caused severe pain: Case report and literature review

Internal nasal dilators are widely used but have not been reported to cause severe symptoms. We describe a case in which a male adult had accidentally, during sleep, inhaled a nasal dilator into his right nasal cavity, and we review the relevant literature. A PubMed search was performed of nasal dilators, especially of the internal types, including "Nasaline Snooze'" (ENTPro, Stockholm, Sweden). A foreign body in adults may be an inhaled nasal dilator. It may be overlooked on computed tomography scans, and thorough inspection of the nose is diagnostic.

Customised acrylic nasal stents following recanalisation of modified Young's procedure

INTRODUCTION

Maintaining the patency of the nasal vestibule following recanalisation of a modified Young's procedure can be a difficult task, as restenosis is quite common.

MATERIALS AND METHODS

Sixteen patients underwent recanalisation of a modified Young's procedure, between January 2005 and December 2007, in the ENT--head and neck surgery department of a tertiary centre. Three different stent types were used following recanalisation: silicone suction tube tips, dental wax plate stents and customised acrylic stents.

RESULTS

The silicone suction tube stents prevented restenosis. They were visible in the post-operative period, and there appeared to be some blunting of the nasal valve region, with no functional impairment. Dental wax plates had a high rate of restenosis and were uncomfortable and unsightly. The customised acrylic stents were more acceptable in the post-operative period, and enabled nasal valve angulation to be maintained.

CONCLUSION

The customised acrylic stent described was a superior alternative to such stenting methods as repeated packing, silicone suction tubes and dental wax plates, following recanalisation of a modified Young's procedure.