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NEUROLOGY &
SLEEP DISORDERS

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they are highly invasive and often lead to less predictable functional averaging 63.4%, 56.2%, 52%, 52.5% and 57.7% at 3, 6, 12, 18
and cosmetic outcomes – leading many ENTs to forgo treating and 24 months, respectively (p<0.001)
NVC. None of these solutions meet the risk-benefit expectations • No adverse change in cosmetic appearance at 24 months post
of either physicians or patients. procedure
• Short learning curve for physicians adopting the technology
An innovative treatment for NVC may provide
durable relief from NAO symptoms While we need to remember that NAO treatment options will al-
A recent innovation has ways depend on the cause, it is important to consider anatomical
enabled physicians to use a issues, including NVC as a possibility. NVC independently affects
new approach for address- the quality of life for NAO patients, and patients fare significantly
ing NAO due to NVC - the worse when left untreated. The availability of a safe, intuitive solu-
LATERA ® absorbable tion to treat NVC patients without altering appearance now enables
nasal implant. This new physicians to administer a durable solution to their condition – and
option has yielded success that should help all of us breathe a bit easier.
for both patients and
physicians as these im- Dr. Jose Barrera, MD practices at the Texas Center for Facial
plants address the anatom- Plastic and Laser Surgery & Endormir Sleep and Sinus Institute
ical issue of a collapsed in San Antonio where he specializes in sleep and nasal surgery.
ABSORBABLY
nasal wall by providing ad- NASAL IMPLANT
ditional support to nasal
wall cartilage and stabilizing its structural integrity. The implant is References
inserted through a small incision and works to support the upper 1. Value calculated based on 2014 US population estimate from US Census
and lower lateral cartilage by anchoring above the maxilla to provide and World Bank data in conjunction with incidence numbers cited in Stewart
cantilever support. Correction of the underlying structural defect et al. Epidemiology and burden of nasal congestion. Intl J Gen Med 2010;
in the nasal wall reduces NAO symptoms and helps patients breathe 2010:3 37-45.
better. Importantly, patients have experienced a minimal risk of any 2. Rhee et al. Nasal Valve Surgery Improves Disease-Specific Quality of Life.
adverse cosmetic changes. Laryngoscope 115: March 2005.
The implant is designed to be absorbed over a period of ap- 3. Crawford-Brown, Theoretical and Mathematical Foundations of Human
proximately 18 months. After implantation, tissue encapsulation Health Risk Analysis; 1997, Page 103.
promotes acute implant stability and enables localized tissue re- 4. Stewart M G. et al.Development and validation of the Nasal Obstruction
sponse during the absorption process. Remodeling occurs once Symptom Evaluation (NOSE) scale. OtolaryngolHead Neck Surg
the implant is replaced with fibrous collagen construct to provide 2004;130 (2) 157- 163.
ongoing support. 5. Wever, The Nasal Airway: A Critical Review; Facial Plast Surg
Positive data were recently presented at the 2017 Annual Meet- 2016;32:17–21.
ing of the American Academy of Facial Plastic and Reconstruc- 6. Camacho et al, The Effect of Nasal Surgery on Continuous Positive Air-
tion Surgery (AAFPRS). The study was conducted in 30 adult way Pressure Device Use and Therapeutic Treatment Pressures: A System-
patients with NVC. Patients had severe or extreme symptoms as atic Review and Meta-Analysis; SLEEP, Vol. 38, No. 2, 2015.
established by the validated Nasal Obstruction Symptom Evalua- 7. Lin et al, Nasal Aerodynamics. May 14, 2015.
tion (NOSE) instrument. A total of 56 implants were placed in 8. Constantian MB, Clardy RB. The Relative Importance of Septal and
these 30 patients, 26 of whom received implants on both sides of Nasal Valvular Surgery in Correcting Airway Obstruction in Primary
the nose. Patients were assessed at 1 week and 1, 3, 6, 12, 18 and and Secondary Rhinoplasty. Plastic and Reconstructive Surgery. 1996 Jul;
24 months post-procedure. 98(1): 47.
9. Ricci, et al. Role of Nasal Valve in the Surgically Corrected Nasal Res-
Key findings of the study include: piratory Obstruction: Evaluation Through Rhinomanometry. American
• Continuing, significant NOSE score reduction at all time points, Journal of Rhinology. September-October 2001, Vol. 15, Nov. 5.

24 San Antonio Medicine • August 2018