Nasal stents are a broad category of devices placed inside the nose to hold tissue open, support healing after surgery, or improve airflow through a narrowed nasal passage. For adults, the term covers everything from disposable over-the-counter dilators you insert at bedtime to silicone splints sutured in place after septoplasty to bioabsorbable implants placed in a doctor’s office for chronic nasal valve collapse. What you need to know before using one depends heavily on which type you’re considering, because the evidence behind each is surprisingly different.
The Different Devices That All Get Called “Nasal Stents”
The confusion starts with language. “Nasal stent” gets used casually to describe at least four distinct products, each with its own purpose, risk profile, and evidence base. Knowing which one applies to your situation matters more than any single piece of advice about stents in general.
- Over-the-counter nasal dilators: Small flexible clips, cones, or adhesive strips that mechanically widen the nasal passage. Internal versions sit inside the nostril; external versions (like Breathe Right strips) pull the outside of the nose outward. These are sold without a prescription and meant for temporary use during sleep or exercise.
- Post-surgical splints: Thin sheets of silicone, Teflon, or similar material placed along the nasal septum after septoplasty or other nasal surgery. A surgeon secures them in place, and they stay for about a week to prevent adhesions and support the healing septum.
- Bioabsorbable implants: Small structural supports made of materials that dissolve over time, placed in an office procedure to shore up a weak nasal sidewall. These target dynamic nasal valve collapse, the condition where the nostril wall caves inward during breathing.
- Drug-eluting sinus stents: Placed during or after endoscopic sinus surgery, these slowly release anti-inflammatory medication into the sinus cavity. They’re designed to reduce scarring and polyp regrowth, not primarily to improve nasal airflow.
The materials used in nasal stents have evolved considerably. Intranasal splints fashioned from X-ray film were first reported in 1955, and since then surgeons have experimented with everything from polyethylene coffee cup lids to dental utility wax to samarium cobalt magnets. Most modern splints use silicone rubber or polytetrafluoroethylene (Teflon), and designs now vary in thickness, flexibility, shape, and whether they include a built-in airway tube so you can breathe through the splint while it’s in place.1PubMed. History of intranasal splints
Post-Surgical Splints After Septoplasty
If you’re having septoplasty to correct a deviated septum, your surgeon will likely discuss whether to use nasal packing, internal splints, or quilting sutures to stabilize the septum during recovery. This is probably the most common context in which an adult encounters nasal stents, and it’s worth understanding the trade-offs.
Traditional nasal packing, typically Merocel sponges stuffed into both nostrils, has been the default for decades. It controls bleeding well but is notoriously uncomfortable. Patients with packing frequently report severe pain, difficulty sleeping, mouth dryness from forced mouth-breathing, and significant distress during removal. Internal splints, usually two thin silicone sheets sutured to the septum on either side, were introduced as a less miserable alternative.
The evidence on splints versus packing is mixed depending on what outcome you care about. A comparative study found that patients with septal splints with a clip experienced less post-operative pain, less tearing, less difficulty swallowing, less mouth dryness, and fewer sleep disturbances than patients with conventional nasal packing.2Bengal Journal of Otolaryngology and Head Neck Surgery. Comparison of Efficacy of Nasal Septal Splints with Clip versus Nasal Packing after Septoplasty Another study comparing silicone splints, plastic splints, and no splints found that silicone versions left patients more comfortable and produced fewer complications overall, though nasal adhesions occurred at higher rates with plastic splints.3International Journal of Current Research and Review. Management of Complications of Septoplasty; a Cross-sectional Comparative Study between Silicon Nasal Splints, Plastic Splints and without Splints for the Correction of the Deviated Nasal Septum
However, a more recent prospective study comparing quilting sutures, nasal packing, and internal silicone splints found that quilting sutures actually came out on top. The packing group had the highest rates of crusting and adhesion formation by the third week of recovery, while quilting sutures were associated with less postoperative pain, less bleeding, and fewer nasal complications than either packing or silicone splints.4The Egyptian Journal of Otolaryngology. The effect of septal quilting sutures, nasal packing, and internal nasal splints on outcomes following septoplasty: a comparative prospective study The takeaway here is that splints are generally better tolerated than packing, but they may not be the best option overall. If your surgeon offers quilting sutures as an alternative, it’s worth asking why or why not.
Bioabsorbable Implants for Nasal Valve Collapse
Nasal valve collapse is a condition where the cartilage-supported sidewall of the nose is too weak to resist the inward suction of breathing, causing the nostril to pinch shut during inhalation. In people with this problem, the external nasal valve area shrinks dramatically during forced inspiration, with one study finding a roughly 42% decrease in valve area compared to almost no change in people with normal nasal anatomy.5PubMed. External nasal valve collapse – a case-control and interventional study employing a novel internal nasal dilator (Nasanita) If you’ve ever noticed that pulling your cheek sideways or pressing on the outside of your nose makes breathing dramatically easier, nasal valve collapse is a plausible cause.
Bioabsorbable implants are a relatively newer treatment for this. They’re placed in an office setting under local anesthesia, threaded under the skin alongside the nose to act as an internal scaffold that keeps the sidewall from collapsing. Because the material dissolves over months, the theory is that scar tissue forms around the implant and provides lasting structural support even after the implant itself is gone.
A twelve-month outcome study of one such implant found that patients’ nasal obstruction scores dropped substantially from baseline and remained improved at every follow-up point through one year. The sidewall itself showed less inward movement on examination at six months compared to before the procedure. About 5% of implants needed to be retrieved, which typically means they shifted out of position or caused local irritation.6PubMed Central. Twelve‐month outcomes of a bioabsorbable implant for in‐office treatment of dynamic nasal valve collapse That retrieval rate is worth knowing about going in: it means that for roughly one in twenty implants placed, a second procedure is needed to remove it.
The alternative to implants for nasal valve collapse has traditionally been open surgical repair using cartilage grafts. Spreader grafts, which are strips of cartilage placed alongside the septum to widen the internal nasal valve, have been shown to restore nasal aesthetics and support the valve, though there’s still debate about how much they improve actual airflow measurements.7PubMed Central. The value of spreader grafts in rhinoplasty: a critical review The office-based implant approach appeals to people who want to avoid general anesthesia and the longer recovery of open surgery, but the long-term data beyond twelve months is still accumulating.
Do Nasal Dilators Help With Snoring and Sleep Apnea?
This is where a lot of adults first encounter the idea of nasal stents, and where the evidence is most likely to disappoint. Over-the-counter nasal dilators are aggressively marketed for snoring, and some people swear by them. But when researchers have tested them rigorously against controls, the results are underwhelming for anything beyond subjective comfort.
A systematic review and meta-analysis pooling data on nasal dilators for sleep-disordered breathing found no significant differences in the apnea-hypopnea index, apnea index, hypopnea index, snoring frequency, total sleep time, sleep architecture, REM latency, oxygen saturation, or nasal airway resistance between people using nasal dilators and controls.8PubMed Central. Clinical Effectiveness of Nasal Dilators in Sleep-Disordered Breathing: A Systematic Review and Meta-Analysis That’s a pretty thorough wash across every metric sleep researchers care about.
An earlier meta-analysis looking specifically at Breathe Right strips and a device called NoZovent reached similar conclusions. When the data was split by device type, external nasal dilators (the adhesive strip kind) did not meaningfully change the number of apnea events per hour. Internal nasal dilators showed a slightly larger reduction in apnea events, but the difference was not statistically significant either. External dilators did produce a small but statistically significant improvement in lowest overnight oxygen saturation, about 1.3 percentage points, while internal dilators showed a similar-sized improvement that did not reach significance.9PubMed Central. Nasal Dilators (Breathe Right Strips and NoZovent) for Snoring and OSA: A Systematic Review and Meta-Analysis
There is one older, much smaller study that told a different story. In eleven patients with habitual snoring or obstructive sleep apnea, a nasal dilator produced a roughly 47% reduction in the apnea index and a measurable improvement in overnight minimum oxygen saturation. Snoring noise also decreased in patients who had been loud snorers during the control night.10JAMA Otolaryngology–Head & Neck Surgery. The Effects of Nasal Dilation on Snoring and Obstructive Sleep Apnea That sounds promising, but eleven patients is a very small sample, and the larger pooled analyses that came later did not replicate the effect. The likely explanation is that nasal dilators may help a subset of people whose obstruction is primarily at the nasal valve rather than in the throat, but they don’t help the broader population of snorers and sleep apnea patients enough to show up in pooled data.
If you snore and are considering a nasal dilator as a standalone fix, the honest picture is that it probably won’t treat sleep apnea. For people whose main complaint is the subjective sensation of a stuffy nose at night, dilators can make breathing feel easier without changing the underlying sleep metrics. That’s not nothing, but it’s not a medical treatment for sleep apnea either.
Internal Versus External Dilators
A review comparing non-surgical nasal devices found that both internal and external nasal dilators relieve nasal obstruction, but internal devices consistently showed greater relief in both objective measurements and patient-reported outcomes.11PubMed Central. The effectiveness of nonsurgical nasal devices in relieving nasal obstruction This makes intuitive sense: an internal dilator physically props the nasal valve open from within, while an external strip pulls the nostril open from the outside through skin tension, which is a less direct force.
The research on nasal valve collapse supports this. When patients with documented alar collapse used an internal nasal dilator, it completely abolished the inward collapse of the nasal sidewall during forced breathing and significantly increased the valve opening during both quiet and forceful inhalation.5PubMed. External nasal valve collapse – a case-control and interventional study employing a novel internal nasal dilator (Nasanita) For someone whose primary issue is valve collapse rather than general congestion, internal dilators are the more targeted option. External strips may still help with comfort, but if you’re looking for the strongest mechanical effect on the valve itself, internal is the way to go.
Nasal Stents and Athletic Performance
Athletes have been taping nasal strips to their faces on the sidelines for decades, but the question of whether nasal dilators actually improve performance during exercise has gotten more rigorous attention in recent years. The answer depends on whether you have a nasal obstruction to begin with.
A study of endurance athletes who had documented nasal valve compromise found that an internal nasal dilator significantly improved nasal patency, maximum oxygen uptake (VO2max), aerobic performance, and self-rated dyspnea and fatigue. Critically, these improvements appeared only in the athletes who had nasal obstruction. The dilator did not produce the same gains in athletes with normal nasal anatomy.12PubMed. Improvement of the aerobic performance in endurance athletes presenting nasal valve compromise with the application of an internal nasal dilator
Another study found that an internal nasal dilator reduced respiratory muscle fatigue during exercise and sped up respiratory muscle recovery afterward, with a significant difference in energy cost during a running test at moderate intensity.13Exercise Science. Effectiveness of a New Internal Nasal Dilator in Pulmonary Function and Exercise Performance A separate trial noted that while heart rate and blood oxygen saturation were the same with and without the dilator, fatigue perception was significantly lower when athletes used one.14PubMed Central. The role of an internal nasal dilator in athletes Lower perceived effort during the same workload is a meaningful benefit, even if it doesn’t show up in the vital signs.
For recreational athletes, the practical conclusion is straightforward: if you notice your nostrils pinching shut during hard breathing, an internal dilator is cheap and worth trying. If your nose feels fine during exercise, the dilator is unlikely to give you a performance edge.
Risks and Complications Worth Knowing About
For over-the-counter dilators, the risk profile is genuinely low. Skin irritation from adhesive strips, mild soreness from internal clips, or discomfort finding the right fit are the main complaints. These are try-and-see devices with little downside beyond wasted money if they don’t work for you.
Post-surgical splints carry more meaningful risks, mostly related to comfort during the days they’re in place. Crusting, mild bleeding when the splint is removed, and the formation of adhesions (scar bands between the septum and the outer nasal wall) are the main concerns. The studies comparing splints to alternatives specifically track these outcomes because they can require additional procedures to treat if they’re severe.
Drug-eluting sinus stents, which are placed during endoscopic sinus surgery, have a more serious potential complication. Case reports have documented persistent mucosal inflammation, granulation tissue formation, and hypersensitivity reactions caused by retained stent material. In some patients, these retained materials also contributed to multifactorial infection in the sinus cavity.15PubMed Central. Stent hypersensitivity and infection in sinus cavities Researchers have been working on addressing this by developing stents coated with sustained-release antimicrobial varnish to reduce bacterial biofilm growth on the stent surface.16Pharmaceutics. Sinonasal Stent Coated with Slow-Release Varnish of Chlorhexidine Has Sustained Protection against Bacterial Biofilm Growth in the Sinonasal Cavity: An In Vitro Study
For bioabsorbable nasal valve implants, the main risk is displacement or extrusion of the implant, which occurred in about 5% of cases in the twelve-month study mentioned earlier. A prosthetic nasal stent used after reconstructive surgery has been noted to carry a low risk of dislocation and aspiration compared to other methods of supporting healing tissue, and it allows patients to return to normal activity relatively quickly after the procedure.17PubMed Central. Prosthetic Management of Post Surgical Nasal Skin Graft Contracture
Compliance Is Harder Than It Sounds
One of the less-discussed realities of nasal stent therapy is that people often stop using them earlier than recommended. While most compliance research has focused on pediatric populations (where parents manage the device), the patterns are informative for adults too. In one study of postoperative nasal stent use after cleft lip repair, 60% of parents reported noncompliance, meaning they stopped using the stent for over a week before the recommended period ended.18PubMed. Use it or Lose it: Predictors of Compliance and Satisfaction With Postoperative Nasal Stent Therapy After Primary Cleft Lip Repair Those numbers reflect the pediatric context, but any adult who has tried sleeping with an internal nasal dilator can appreciate how discomfort and inconvenience erode adherence over time.
For over-the-counter dilators, the stakes are low: if you stop wearing one, the worst outcome is returning to your baseline nasal obstruction. For post-surgical splints, early removal against medical advice can lead to adhesion formation, septal hematoma, or displacement of the repaired septum. If your surgeon placed a splint and scheduled a removal date, that timeline exists for a reason, and removing the splint early yourself is one of the riskier things you can do during recovery.
Hygiene for Reusable Nasal Devices
If you’re using a reusable internal nasal dilator, cleaning it between uses matters more than most people realize. The warm, moist nasal cavity is an ideal environment for bacterial colonization, and a device you insert nightly accumulates biofilm quickly. Most manufacturers recommend washing with mild soap and warm water after each use and replacing the device every few weeks to months depending on the material.
For post-surgical applications, patient education about precautions and proper cleaning of nasal irrigation devices is considered essential to prevent complications.19PubMed Central. Sinonasal Irrigation After Endoscopic Sinus surgery – Past to Present and Future Saline irrigation is commonly recommended during the healing period after surgery to keep crusting under control and flush debris from around splints or stents. If you’re using a squeeze bottle or neti pot for this, using sterile or previously boiled water rather than tap water is a standard precaution, since the nasal passages connect to spaces that don’t handle waterborne microorganisms well.
When Nasal Stents Are Not the Right Fix
Not all nasal obstruction originates at the nasal valve or septum. Chronic congestion from allergic rhinitis, nasal polyps, or turbinate hypertrophy may not respond meaningfully to a mechanical device that holds the valve open. If your stuffiness is driven by swollen mucous membranes deeper inside the nose, a stent at the entrance won’t address the upstream problem. The same logic applies to the sleep apnea data: most obstructive sleep apnea involves collapse of the soft palate or base of the tongue in the throat, not the nasal valve, which is why nasal dilators don’t budge the apnea-hypopnea index in pooled studies.
People with active nasal infections or significant nasal skin conditions should also avoid inserting over-the-counter devices until those issues resolve. And if you have a history of reactions to silicone or adhesive materials, testing a dilator briefly before committing to overnight use is a sensible step. For post-surgical stents, your surgeon will evaluate whether the type of repair performed benefits from a splint. Not every septoplasty needs one, and increasingly the trend is toward suture techniques that avoid stents altogether where feasible.