Treating Symptomatic Midvault Soft Tissue Collapse in Revision Rhinoplasty with a Nasal Wall Implant

Seyidova N, Chen AD, Kazei D, Lin SJ.

PubMed 32766052 Publisher (DOI)Free full text (PMC)

What this paper says

Eight absorbable lateral nasal wall implants were placed in 6 revision patients with side wall collapse; 4 of 6 reported improved breathing and all reported improvement in the collapse, over a mean 16 months.

Overview

Persistent blockage from collapse of the soft tissue side wall after previous nasal surgery is difficult to treat. An absorbable implant placed in the lateral nasal wall is one option, but it had not been studied in complex revision cases with patient-reported outcomes. This study reports that use.

Sections of note

Data were collected on all patients with previous nasal procedures who had a Latera implant placed together with functional rhinoplasty from January to December 2018.
Outcomes used the Nasal Obstructive Symptom Evaluation and a visual analogue scale.
8 implants were placed in 6 revision functional rhinoplasty patients with midvault collapse; all responded to the survey.
Mean follow-up 16 months, SD 4.
No implant-related adverse events occurred.
Mean NOSE score 33 SD 33; mean visual analogue scale score 20 SD 9.
Symptoms afterward: 1 complete resolution, 2 mild, 1 moderate, 1 severe, 1 extreme. 4 of 6 reported improvement in obstruction; all reported improvement in the collapse itself.

What it means for a patient

The implant dissolves over time while supporting the side wall as scar tissue forms around it.
Four of six patients breathed better, but two still described severe or extreme symptoms afterward.
The standard deviation on the NOSE score equals the mean, indicating very wide variation between these patients.
Limits: 6 patients, one center, no comparison group, and the authors note obstruction in revision cases is often multifactorial.

Why this paper matters

Side wall collapse after previous surgery has few good options, since the tissue that would normally support it is scarred or gone. An absorbable implant avoids permanent foreign material. Six patients with widely varying results cannot establish how well it works.

Terms

Midvault soft tissue collapse: The side wall of the nose falling inward on breathing in.
Lateral nasal wall implant: An absorbable device placed to support that side wall.
Nasal airway obstruction: A blocked or restricted nasal airway.
NOSE score: The Nasal Obstruction Symptom Evaluation, a validated blockage questionnaire.
Functional rhinoplasty: Nasal surgery aimed at breathing rather than appearance.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

Abstract

Persistent nasal airway obstruction (NAO) due to midvault soft tissue collapse in patients following rhinoplasty or nasal surgery is a clinical challenge for surgeons. An absorbable lateral nasal wall implant is one option available to help treat midvault soft tissue collapse and to improve NAO symptoms. Previous studies have not investigated its use in complex revision functional rhinoplasty with respect to patient-reported outcomes. Data were collected on all patients with a history of previous nasal procedures who underwent Latera implant placement in conjunction with functional rhinoplasty from January to December 2018. The Nasal Obstructive Symptom Evaluation and Visual Analogue Scale were used to evaluate functional outcomes. Eight implants were placed in 6 revision functional rhinoplasty patients with midvault collapse. All patients responded to the survey. Mean follow-up was 16 ± 4 months. There were no implant-related adverse events. Mean Nasal Obstructive Symptom Evaluation score was 33 ± 33, and mean Visual Analogue Scale score was 20 ± 9. In total, 1 patient reported complete resolution of NAO, whereas 2 patients reported mild, 1 reported moderate, 1 reported severe, and 1 reported extreme symptoms. Four of the 6 patients reported nasal obstruction improvement, with all reporting improvement in midvault soft tissue collapse. Apart from being used in nasal valve collapse treatment, a lateral nasal wall implant is a potentially useful solution that may help surgeons improve patients' NAO symptoms in complex functional rhinoplasty cases. However, in certain cases, a patient's nasal obstructive symptoms may continue to be multifactorial.

Abstract as indexed by PubMed; the article is open access (PubMed Central).