Bioabsorbable Nasal Implants ARS Position Statement

The American Rhinologic Society (ARS) supports the use of a bioabsorbable nasal implant to treat nasal obstruction due to nasal valve collapse (CPT code 30468). This procedure should not be considered experimental, but should be considered as an effective option in treating nasal valve collapse and improving patient quality of life in those suffering from nasal airway obstruction due to nasal valve collapse based on the following data.

Nasal valve collapse is a common finding in otolaryngology practices evaluating patients for nasal obstruction. In a study by Clark, et al, the authors identified a prevalence of 73% of nasal valve collapse in patients (n=1906) identified as having severe or extreme nasal airway obstruction based on a validated survey of nasal obstruction1,2. Traditional methods to address nasal valve collapse involve an open septorhinoplasty approach with the placement of variouscartilage grafts. There are currently bioabsorbable implants in the market that represent an alternative approach to treat the problem of nasal valve collapse. Initial studies in humans demonstrated safety and tolerance of the device as well as efficacy for the treatment of nasal airway obstruction via the absorbable implant for support of the lateral nasal cartilages through 18 months post-procedure3. These data were further supported prospectively to the 6-month mark, demonstrating improvement in NOSE survey scores and sustained safety profile of the absorbable implant4.Furthermore, in a randomized control trial comparing the bioabsorbable implant to a sham control procedure, patients in the treatment arm demonstrated a significantly greater decrease in NOSE score and significantly lower visual analogue scale (VAS) scores compared to patients in the sham control group5.

Given these data on safety and efficacy, the ARS supports the use of a bioabsorbable implant to treat patients presenting with nasal airway obstruction due to nasal valve collapse. We do not consider absorbable implants to be experimental and urge all payors to support the use of absorbable nasal implants in the treatment of patients with nasalvalve collapse.


 

  1. Clark DW, Del Signore AG, Raithatha R, Senior BA. Nasal airway obstruction: Prevalence andanatomic contributors. Ear Nose Throat J. 2018 Jun;97(6):173-6.
  2. Stewart MG, Smith TL, Weaver EM, Yueh B, Hannley MT. Outcomes after nasal septoplasty: Results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) study. Otolaryngol Head Neck Surg 2004 130(3):283-90.
  3. San Nicolo M, Stelter K, Sadick H, Bas M, Berghaus A. Absorbable Implant to Treat Nasal Valve Collapse. Facial Plast Surg, 2017 33(2):233-40.
  4. Stolovitzky P, Sidle DM, Ow RA, Nachlas NE, Most SP. A prospective study for treatment of nasal valve collapse due to lateral wall insufficiency: outcomes using a bioabsorbable implant. Laryngoscope. 2018 Nov;128(11):2483-9.
  5. Stolovitzky P, Senior B, Ow RA, Mehendale N, Bakhazi N, Sidle DM. Assessment of bioabsorbable implant treatment for nasal valve collapse compared to a sham group: a randomized control trialInt ForumAllergy Rhinol. 2019 Aug;9(8):850-6.