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A Comparison of Over-the-Counter Mechanical Nasal Dilators A Systematic Review

Nicole Kiyohara, BA1,2; Christopher Badger, BS1,2; Tjoson Tjoa, MD3; Brian Wong, MD, PhD2,4,5,6
[+] Author Affiliations
1School of Medicine, University of California–Irvine
2Beckman Laser Institute and Medical Clinic, University of California–Irvine
3Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston
4Department of Otolaryngology, Head and Neck Surgery, University of California–Irvine, Orange
5Department of Otolaryngology, Head and Neck Surgery, University of California–Irvine
6Department of Biomedical Engineering, University of California–Irvine
JAMA Facial Plast Surg. 2016;18(5):385-389. doi:10.1001/jamafacial.2016.0291.
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Importance  The internal nasal valve is the narrowest part of the nasal airway and a common site of inspiratory collapse and obstruction of nasal airflow. Over-the-counter mechanical nasal dilators are an alternative to surgical intervention that attempts to improve airflow through the internal nasal valve.

Objective  To determine the efficacy of over-the-counter mechanical nasal dilators and classify these products by mechanism.

Evidence Review  A database of 33 available over-the-counter mechanical nasal dilators was generated via a PubMed search as well as an internet search via Amazon.com and Google, conducted from April 1, 2013, through December 31, 2015. Products determined to be unavailable or discontinued were excluded from the database. Of the devices examined in published literature, efficacy was based on objective measures, such as measured airflow, the cross-sectional area of the nasal valve, and changes in resistance. Measures of reported sleep quality or patient perception were excluded.

Findings  An analysis of each product’s mechanism revealed 4 broad classes: external nasal dilator strips, nasal stents, nasal clips, and septal stimulators. A review demonstrated 5 studies supporting the use of external nasal dilator strips, 4 studies supporting the use of nasal clips, 1 study supporting the use of nasal stents, and no studies supporting the use of septal stimulators.

Conclusions and Relevance  Our findings suggest that external nasal dilator strips and nasal clips effectively relieve obstruction of the internal nasal valve and may be an alternative to surgical intervention in some patients.

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Figure.
Nasal Dilator Products Available to US Consumers

A, External nasal dilator strips are adhesive strips placed over or adjacent to the bridge of the nose. The strips increase the diameter of the internal nasal valve by pulling externally on the lateral walls of the nasal vestibule. B, Nasal stents are placed in each nostril and apply an outward force circumferentially at the internal nasal valve. C, Nasal clips have a segment that connects the 2 ends, each inserted into a nostril to apply an outward force onto the lateral nasal wall. D, Septal stimulators apply pressure on the nasal septum to increase nasal circulation and promote the opening of nasal passages.

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