Q: Dr. Eppley, I had my appointment with my ENT today (virtual consult). He said it seems like a nasal valve collapse. I have to go in physically once the covid-19 lockdown ends. He said there’s an option to have an implant called Lateral or I would need another rhinoplasty to fix it. Is this something that you could fix? He said I’d have to pay out of pocket regardless as insurance doesn’t typically cover it so I wanted to consider my options.
A: When it comes to nasal valve collapse, the first question regardless of the treatment is whether adding internal nasal valve support will help. This can be confirmed if one as a positive response to either Breathe Right strips or the physical Cottle manuever. (pulling out on the cheeks will pulls the nostrils out wider). With nasal valve collapse there are two treatment approaches, cartilage grafting and the Latera resorbable implant. Cartilage grating is the gold standard treatment and involves the placement of cartilage grafts between the septum and the upper lateral cartilage which if done in isolation (which is all you need) can be done through a closed rhinoplasty. The Latera absorbable nasal implant strives to open the internal nasal valve and is placed inside the lateral (side) wall of the nose to lift the nasal cartilages outward. (like an internal Cottle manuever) It is very effective but is made of an absorbable material that will go away over a period of year or so when its effects will be lost as the material is absorbed.
Dr. Barry Eppley