At UPMC Children's Hospital of Pittsburgh, we believe parents and guardians can contribute to the success of this surgery and invite you to participate. Please read the following information to learn about the surgery and how you can help.
Nasal Stenting Fast Facts
- There are two different types of stents. We use both routinely and we will choose which we think best.
- We generally recommend stenting for three to six months to achieve the best outcome. We will adjust this if needed based on the post-operative course.
- Sometimes we will change the size of the stents. Most often this will be 'up-sizing', or increasing the size, during the post-operative course. Please take note of how the stents fit in your child's nose so that we know if they seem tight or loose to you should this be discussed. If you have questions regarding fit, please reach out to us.
What Are Nasal Stents?
As you get closer to surgery, your team may talk to you about nasal stents. Stents might be recommended after a lip adhesion, a lip/nose repair or both.
They are generally used for three to six months. That duration might be adjusted as needed during the post-operative period.
Looking down at your stents
We often cut them in the OR to shorten the tube (pictured here). If we send you an additional set of stents, they will likely not be cut. You can cut them to a similar length as your original pair. The angled cut may or may not be present.
The front view of your stents
They look like an egg. When they go in, the narrow side (top of the egg) goes up towards the eyes. Orientation is based on the shape of the opening, not the angle of the cut tube.
Inserting nasal stents
Narrow side Up!
Cut two steri-strips about ½ of the way down the sheet (shorter might work better for you). Cut a third strip a little longer than the first.
Flip the steri up so that the sticky sides meet – grabbing the wing so that the steri-strip will be angled up (toward the eyes) with sticky side towards the stent tube (towards the face).
Repeat for the other side with the other short steri-strip.
Apply a small amount of bacitracin or Vaseline® to the outside of the tube. Avoid obstructing the opening and getting it on the wings.
Putting the stents in might be a two-person job! Secure your baby's head with your wrists while a second person helps with arms. Aim the stents a little bit in towards the septum and down. Stop if you hit a blockage, pull back and aim in and down again.
Place the tape over the nose, one side at a time. This is shown with the 'skinny' tape, cut longer. You may prefer the 'wider' tape or that it be cut shorter to stay on top of the nose.
(Wider tape, cut shorter)
Remember the third piece you cut? That can be used to "reinforce" the other two by crossing it over the top of the nose. Shown here after lip adhesion. This is only if you find it to be helpful.
The stents may creep out a smidge. As long as they aren't moving, are staying in and do not irritate the nose, that is OK! You can fix them the next time you replace them.
Types of Nasal Stents
There are two different types of stents and we will choose which one we think best for your child. Notice the difference in the "wings" or the sides of the stents. The best way to tape may depend on which type of stent you have.
The wings with loops will allow you to tape out to the cheeks. If your stents do not have loops on the wings, there are other techniques to tape to the cheeks.
But you can still use the original technique and tape over the nose!
If your wings do not have loops and taping over the nose is not working, you can also try taping to the cheeks.
There are two techniques for this:
1.) Loop the steri around the wing so that it points down instead of up, and then bend it so it points out to the side, sticky side down.
2.) We can give you orthodontic rubber bands and you can "grab" those to angle the tape out to the side (as below).
Some babies have sensitive cheeks! If you are worried that your child's cheeks are or may become irritated, we can provide you with DuoDERM® to act as a contact surface for the steri-strip. This works best if taping to the cheeks.
When to Call
- The stent wings are FRAGILE. When changing your steri-strips be VERY careful to avoid unnecessary breaking. Use scissors to remove tape rather than pulling it off. If the wings break, call so that we can replace.
- Remove if your baby seems to be working hard to breathe so stents can be cleaned. If this resolves with cleaning, resume stenting. If not, call immediately.
- Call with any nostril redness/irritation.
- If you notice blanching or a 'white' look to the nostrils or nasal tip when placing stents (especially if we change size of stents) that does not resolve in 10 to 15 minutes, please remove stents and call!
- Clean at least once a day (run under water, remove any mucus) and as needed with congestion.
- Call if you find you need to change them more than two to three times/day.
- Sometimes we need to alter the usage if your child has cold/increased congestion. Please call if this occurs.
