Name of the Procedure:

Insertion, Nasal Septal Prosthesis (Button)

Common name(s): Nasal button insertion, Septal button placement

Summary

The insertion of a nasal septal prosthesis, commonly known as a nasal button, is a minor surgical procedure to place a small medical device into the nasal septum. This device helps bridge a perforation in the septum, providing mechanical closure and relief from associated symptoms.

Purpose

The nasal button is used to treat a perforated nasal septum, a condition where there's a hole in the septum, which separates the nostrils. The goal of the procedure is to alleviate symptoms such as nasal crusting, bleeding, whistling during breathing, and recurrent infections.

Indications

• Presence of a symptomatic nasal septal perforation.
• Patients with persistent symptoms unresponsive to conservative treatments.
• Specific contraindications to more invasive surgical repair.

Preparation

• Patients may be advised to avoid eating or drinking for a few hours before the procedure.
• Pre-procedure nasal decongestion with topical sprays.
• Diagnostic nasal endoscopy to assess the size and location of the perforation.
• Medical history review and allergy check for anesthesia.

Procedure Description

1. The patient is positioned comfortably, typically in a reclining chair.
2. Local anesthesia is administered to numb the nasal septum.
3. The prosthesis (button) is carefully sized to fit the perforation.
4. The button is then inserted through the nostrils and guided into place, ensuring it spans the perforation.
5. The device is adjusted for a snug, secure fit to prevent shifting and ensure comfort.

Tools and Equipment:

• Nasal endoscope, nasal speculum.
• Sterile nasal button prosthesis.
• Local anesthetic agents and applicators.

Duration

The procedure typically takes about 30 minutes to an hour.

Setting

This procedure is generally performed in an outpatient clinic or a surgical center.

Personnel

• ENT (Ear, Nose, and Throat) specialist or otolaryngologist.
• Nursing staff to assist and monitor the patient.

Risks and Complications

• Common risks: Minor bleeding, nasal discomfort, or irritation.
• Rare risks: Infection, ulceration around the button, dislodgement, or rejection of the prosthesis.
• Management: Antibiotics for infection, adjustments or replacement of the prosthesis if necessary.

Benefits

• Immediate relief from symptoms associated with septal perforation.
• Improved nasal function and comfort.
• Non-invasive alternative to surgical repair.

Recovery

• Patients can usually go home shortly after the procedure.
• Instructions to avoid nasal trauma and vigorous nose blowing.
• Regular saline nasal irrigation to keep the area clean.
• Follow-up appointments to monitor the placement and condition of the prosthesis.
• Full recovery and adaptation typically occur in a few days to a week.

Alternatives

• Conservative management with nasal saline sprays and gels.
• Surgical repair of the septal perforation, which involves stitching or grafting tissue.
• Pros of alternatives: Possible permanent solution with surgical repair.
• Cons: Higher risk and longer recovery time with surgery.

Patient Experience

• During the procedure, patients will feel pressure but minimal pain due to local anesthesia.
• Post-procedure, mild discomfort and nasal congestion might be experienced.
• Pain management with over-the-counter pain relief if necessary.
• Overall, most patients find significant relief from their symptoms shortly after the procedure.