Septal Splinting in complex septa using a modified Titanium implant

Introduction: Complex deviations of the caudal or anterior septal margins can be treated with splinting techniques. Splinting with autologous material (cartilage, bone) is not always effective or available. In these cases, we started using a modified titanium Breathe Implant^® (off-label), first described by Prof. à Wengen^[1]. Our observational study assesses the safety and versatility of this approach.

Material & Methods: This retrospective study (12/2022-01/2023) examines patients undergoing titanium splinting. A self-designed questionnaire evaluated implant-related complications (e.g. foreign body sensation, extrusion, palpability) and self-estimation of nasal breathing (NB) on a Linkert scale (1-10) at three time points.

Results: Between 08/2018-10/2022, 85 patients underwent titanium splinting. Feedback was obtained from 52 patients (61%). The mean follow-up was 37 months. No permanent implant-related complications were reported. Minor problems included a non-disturbing cold sensation at -15°C and an endonasal exposure that healed completely within two months. No revision surgery was required. Postoperative NB improved from 3.5/10 to 7.9/10.

(Fig.1) Intraoperative findings before (A) and after (B) titanium splinting

(Fig.2) Number of titanium implant procedures

(Fig.3) Follow-up time

(Tbl.1) Survey results

(Fig.3:) NB at three time points

Conclusion: In our experience, titanium splinting proves safe and effective for correcting complex septal deformities, especially when autologous material is insufficient. Our cohort, with the largest number of alloplastic splinting to date, showed no permanent implant-related complications. A prospective study objective measurements and longer follow-up is planned.

References: [1] àWengen DF, Arch Otolaryngol Rhinol 2019

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