Structural Support: Surgeons extol the cartilage stability provided by a new nasal implant

"It is excellent in applications where temporary support without adding permanent bulk is needed." – Dean M. Toriumi, MD

Along with the still evolving indications for use, physicians need to be aware of situations in which the implant is contraindicated. According to Drs. Saleh and Wong, the main contraindication is in patients who have had an adverse reaction to PDS sutures previously. Dr. Wong also cautioned against using the PDS plate on both sides of a cartilage graft to avoid compromising the nutrient supply to the graft, and said not to use it without complete and robust coverage by well-perfused soft tissue to avoid exposing the implant in the nasal fossa.

Dr. Constantinides emphasized the importance of not leaving the implant exposed in the nasal fossa, such as would happen in patients with a septal mucosa that is torn bilaterally; he said having the plate exposed intranasally for many weeks would disallow the survival of any attached cartilage.

Perhaps the most essential thing to note, Dr. Toriumi said, is that the PDS plate is not a replacement for cartilage and should not, for example, be used in place of cartilage for a spreader graft or alar batten graft. ENT TODAY