Nicole Kiyohara1, Christopher Badger1, Tjoson Tjoa2, Brian Wong3. 1. School of Medicine, University of California-Irvine2Beckman Laser Institute and Medical Clinic, University of California-Irvine. 2. Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston. 3. Beckman Laser Institute and Medical Clinic, University of California-Irvine4Department of Otolaryngology, Head and Neck Surgery, University of California-Irvine, Orange5Department of Otolaryngology, Head and Neck Surgery, University of California-Irvine6Department of Biomedical Engineering, University of California-Irvine.
Abstract
IMPORTANCE: The internal nasal valve is the narrowest part of the nasal airway and a common site of inspiratory collapse and obstruction of nasal airflow. Over-the-counter mechanical nasal dilators are an alternative to surgical intervention that attempts to improve airflow through the internal nasal valve. OBJECTIVE: To determine the efficacy of over-the-counter mechanical nasal dilators and classify these products by mechanism. EVIDENCE REVIEW: A database of 33 available over-the-counter mechanical nasal dilators was generated via a PubMed search as well as an internet search via Amazon.com and Google, conducted from April 1, 2013, through December 31, 2015. Products determined to be unavailable or discontinued were excluded from the database. Of the devices examined in published literature, efficacy was based on objective measures, such as measured airflow, the cross-sectional area of the nasal valve, and changes in resistance. Measures of reported sleep quality or patient perception were excluded. FINDINGS: An analysis of each product's mechanism revealed 4 broad classes: external nasal dilator strips, nasal stents, nasal clips, and septal stimulators. A review demonstrated 5 studies supporting the use of external nasal dilator strips, 4 studies supporting the use of nasal clips, 1 study supporting the use of nasal stents, and no studies supporting the use of septal stimulators. CONCLUSIONS AND RELEVANCE: Our findings suggest that external nasal dilator strips and nasal clips effectively relieve obstruction of the internal nasal valve and may be an alternative to surgical intervention in some patients.
IMPORTANCE: The internal nasal valve is the narrowest part of the nasal airway and a common site of inspiratory collapse and obstruction of nasal airflow. Over-the-counter mechanical nasal dilators are an alternative to surgical intervention that attempts to improve airflow through the internal nasal valve. OBJECTIVE: To determine the efficacy of over-the-counter mechanical nasal dilators and classify these products by mechanism. EVIDENCE REVIEW: A database of 33 available over-the-counter mechanical nasal dilators was generated via a PubMed search as well as an internet search via Amazon.com and Google, conducted from April 1, 2013, through December 31, 2015. Products determined to be unavailable or discontinued were excluded from the database. Of the devices examined in published literature, efficacy was based on objective measures, such as measured airflow, the cross-sectional area of the nasal valve, and changes in resistance. Measures of reported sleep quality or patient perception were excluded. FINDINGS: An analysis of each product's mechanism revealed 4 broad classes: external nasal dilator strips, nasal stents, nasal clips, and septal stimulators. A review demonstrated 5 studies supporting the use of external nasal dilator strips, 4 studies supporting the use of nasal clips, 1 study supporting the use of nasal stents, and no studies supporting the use of septal stimulators. CONCLUSIONS AND RELEVANCE: Our findings suggest that external nasal dilator strips and nasal clips effectively relieve obstruction of the internal nasal valve and may be an alternative to surgical intervention in some patients.
Authors: Matteo Gelardi; Giuseppe Porro; Brigida Sterlicchio; Nicola Quaranta; Giorgio Ciprandi; Italian Study Group On Sonoring Journal: Acta Biomed Date: 2019-01-11