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Repair of nasal valve collapse with subcutaneous/submucosal lateral wall implant(s)

CPT4 code

Name of the Procedure:

Repair of Nasal Valve Collapse with Subcutaneous/Submucosal Lateral Wall Implant(s)

Summary

This procedure involves inserting small implants under the skin or mucous membrane in the lateral walls of the nose to support the nasal valve. This helps to open the nasal passages and improve breathing.

Purpose

The procedure addresses nasal valve collapse, a condition that can cause nasal obstruction and difficulty breathing through the nose. The goal is to reinforce the structural integrity of the nasal passages, thereby improving airflow and reducing symptoms of nasal congestion and blockage.

Indications

  • Chronic nasal obstruction that does not respond to medical treatments
  • Difficulty breathing through the nose
  • Diagnosis of nasal valve collapse confirmed by a healthcare provider
  • Patients with anatomical nasal valve weaknesses or previous nasal surgeries that have compromised the nasal valve

Preparation

  • Patients may need to avoid eating and drinking for a few hours before the procedure.
  • Certain medications, especially blood thinners, may need to be adjusted or stopped as advised by the healthcare provider.
  • A thorough medical history, physical examination, and possibly imaging studies like a CT scan are required to assess the nasal structure.

Procedure Description

  1. Anesthesia: Local anesthesia is typically used to numb the area, though sedation may be an option for additional comfort.
  2. Incision: A small incision is made in the lateral wall of the nasal cavity.
  3. Implant Insertion: Specialized subcutaneous or submucosal implants are placed into the lateral wall of the nose to support and open the nasal valve.
  4. Closure: The incision is closed with dissolvable sutures or medical adhesive.

Tools and equipment commonly include surgical instruments for cutting and suturing, specialized implants for nasal support, and anesthesia supplies.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

This procedure is usually performed in an outpatient surgical center or hospital.

Personnel

  • Otolaryngologist (ENT surgeon)
  • Nursing staff
  • Anesthesiologist or anesthesia provider (if sedation is used)

Risks and Complications

  • Infection at the incision site
  • Bleeding
  • Scarring
  • Displacement or rejection of the implant
  • Temporary or permanent changes in nasal appearance
  • Persistence or recurrence of nasal obstruction

Benefits

  • Improved nasal airflow and breathing
  • Relief from chronic nasal congestion and obstruction
  • Better quality of life with enhanced ability to exercise and sleep

Patients can typically notice an improvement in symptoms soon after recovery from the procedure.

Recovery

  • Patients may experience swelling, bruising, and mild discomfort, which can be managed with pain medication.
  • Nasal splints or packing may be used and will be removed during a follow-up visit.
  • Avoid strenuous activities and follow specific post-operative care instructions provided by the surgeon.
  • Full recovery usually takes about 1 to 2 weeks, with follow-up appointments to monitor healing and implant positioning.

Alternatives

  • Non-surgical treatments such as nasal dilators, steroid nasal sprays, or decongestants.
  • Functional rhinoplasty or septoplasty for more severe structural problems.
  • Continuous Positive Airway Pressure (CPAP) therapy for breathing support.

Each alternative has its pros and cons, such as varying degrees of invasiveness, effectiveness, and recovery time.

Patient Experience

  • During the procedure: Patients may feel some pressure or discomfort, managed by anesthesia.
  • After the procedure: Swelling, bruising, and mild pain are common but temporary. Pain can be controlled with prescribed medication, and most patients can return to normal activities within a week.

Comfort measures include cold compresses and staying elevated while resting to reduce swelling.

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