This is a relatively new procedure that is done in the office to help improve symptoms of nasal blockage due to weak or collapsing nostrils. It is done in the office with local anesthesia or in the operating room with general anesthesia when combined with other more invasive procedures (sinus surgery, septoplasty, turbinoplasty). A special device called the Latera Implant System is used to place temporary implants (lasts for 2 years) under the skin of the nose above the nostrils. These implants act as a cantilever device that stents open the nostrils when patients breathe in (feels like wearing Breathe Rite Strips all the time!). Clinical trials have shown this to be an effective approach for nasal valve collapse symptoms. Previously a much more invasive surgery was done where the nose is fully opened up and cartilage grafts are placed to support the nostrils. While a highly effective and permanent solution the extent of the surgery has deterred many patients from pursuing it and opting instead for a less invasive approach.
Indications: Latera implants are indicated for patients that have tried medical management (antibiotics, nasal sprays, allergy treatment, saline rinses) but are still having nasal blockage due their nostrils collapsing when they breathe in.
Preparation: Patients are given full instructions to follow for 1 week prior to their procedure. In addition, patients also continue any medical management that has been used for their nasal problems previously. Certain medications like aspirin and other blood thinners will need to be stopped in advance of the procedure. Patients may have a light breakfast the day of the procedure. Photographs may be needed to show the nostril collapse for some insurance carriers as part of the authorization process. Glasses also should not be worn for 1 week after the procedure, so patients need to be prepared for that.
What to expect during the procedure: Latera is performed in the office and with local anesthesia or in the operating room with general anesthesia when performed in combination with more invasive procedures (septoplasty, turbinoplasty, sinus surgery). When done in the office before the procedure is started, the nose is sprayed with a numbing spray to provide comfort during the procedure. Additional injections are done with very small needles to numb the areas where the implants will be placed. Patients feel some pressure as the ilant is being placed and Dr Jafri tells the patient when and exactly what they will. The implants are usually done on both sides and takes 15 to 30 seconds minute to complete. We take our time with the numbing process to make sure the procedure is comfortable for you. Oral Valium can also be used to help patients relax.
Recovery and Follow Up: Given that Latera is a minimally invasive procedure, the recovery process is limited and short. Most patients will have a spotty nosebleed and nasal congestion for 2 days after the procedure. Tylenol can be taken as needed but majority of patients have no pain – only nasal congestion. Patients are not allowed to press on their nose, wear glasses or blow their nose too hard for a limited period of time. Normal activity with some minor restrictions that are outlined in the instructions can be resumed after 3 days in most cases. Follow up is usually done within 2 weeks after the procedure and sooner as needed. Dr Jafri personally calls you after the procedure and patients are given direct access to his number for any questions and concerns during the recovery process.
Costs: Latera is covered by insurance. Our office will check your insurance coverage and advise of any potential costs based on your specific plan prior to scheduling any procedure. We can also provide you with the relevant CPT codes so you can speak with your insurance provider as well. Some insurance carriers require pictures of the nostril collapse as part of the authorization process.
Risks: All procedures have inherent risks, benefits, alternatives and complications associated with them and to the specific individual patient being treated. Dr Jafri will review these with you in detail and answer any questions you have before you proceed with any procedure and as part of the process of whether to proceed or not.