Anyone with nose cartilage shaved to fit pillow?

Just up from my tip of my nose, I have a one-sided inner nostril cartilage bump. The ENT is willing to cut the bump, under a local only, so the nasal pillows can fit without constant irritation. He states that I will be able to use the pillow again in a week. Is this going to far to get a mask to fit?

The nasal mask leaks so much especially if I use the Gecko pad to prevent bridge soreness. The pillows are so comfortable on my good nostril side.

Knife or FF mask, I choose FF mask over a cut body part any day. Jim

Goofproof wrote:Knife or FF mask, I choose FF mask over a cut body part any day. Jim

+1

unsuspected Severe OSA | (Kitatonic) | (stevos2000) wrote:Just up from my tip of my nose, I have a one-sided inner nostril cartilage bump. The ENT is willing to cut the bump, under a local only, so the nasal pillows can fit without constant irritation. He states that I will be able to use the pillow again in a week. Is this going to far to get a mask to fit?

The nasal mask leaks so much especially if I use the Gecko pad to prevent bridge soreness. The pillows are so comfortable on my good nostril side.

The system suggests you've joined as both Kitatonic (21 posts, member since 12/16/2011, PR System One) and stevos2000 (13 posts, joined 09/29/2011, Resmed S9).

So are you Stevos2000 or Kitatonic or both? Hmmm...

Stevos2000 is my husband and I can''t post as Kitatonic with my listed equipment. I will try to clean this up with a new name and good avatar or I'll just cease to post.

I respectively disagree with goofproof and dreamdiver when goofproof says:

Goofproof wrote:Knife or FF mask, I choose FF mask over a cut body part any day. Jim

My rationale? It's based on this statement by the OP:

unsuspected Severe OSA wrote: The nasal mask leaks so much especially if I use the Gecko pad to prevent bridge soreness. The pillows are so comfortable on my good nostril side.

If a nasal mask causes soreness on the bridge of the nose that can only be relieved with a pad that then triggers too many leaks, chances are a FFM will cause even more nose bridge pain without a pad and have more issues with leaks than the nasal mask does with the pad. Switching to a FFM seems like setting the OP up for a lifetime of struggling with unnecessary bridge pain and/or battles with leaks.

The proposed surgery is to be done under a local and my guess is that it would be done as an ambulatory patient. Probably it involves less than an hour of time from start to finish with a week of recovery time before being able to use the desired nasal pillows mask. (It is worth clarifying whether you can use the nasal mask while healing from the surgery or whether CPAP itself needs to be discontinued for a week.)

Seems to me the long-term comfort of being able to use the desired mask that works well now except for the nasal irritation is well worth the minor surgery in my opinion.

Thank you, Robysue, I really trust your judgement. Yes, I will be able to use my nasal mask for the week off the pillows. I made it very clear to the doctor that with my OSA (desats to the 60s/AHI 49), I must be able to continue CPAP. Before I have my nostril bump excised under a local (declined sedation), I'll try to order a Mirage FX for Her which now comes in a small mask size. Doesn't sound like anyone else has had this done, so I'll proceed cautiously. There seems to be a lot of folks who alternate between pillows & nasal, so if I can achieve a good seal with a new nasal mask, I'll just stick to alternating based on soreness.

unsuspected Severe OSA wrote:Thank you, Robysue, I really trust your judgement. Yes, I will be able to use my nasal mask for the week off the pillows. I made it very clear to the doctor that with my OSA (desats to the 60s/AHI 49), I must be able to continue CPAP. Before I have my nostril bump excised under a local (declined sedation), I'll try to order a Mirage FX for Her which now comes in a small mask size. Doesn't sound like anyone else has had this done, so I'll proceed cautiously. There seems to be a lot of folks who alternate between pillows & nasal, so if I can achieve a good seal with a new nasal mask, I'll just stick to alternating based on soreness.

I had a deviated septum fixed (and sinus surgery) before I knew I had OSA and I am really glad I did because I love using a nasal pillow and doubt I would have been able to otherwise. I didn't like the nasal mask at all - it was hard to get a good seal and rubbed everywhere. As Robysue stated, a week of discomfort weighed against perhaps years of added comfort with your CPAP - that would be an easy choice for me.

Good look with the procedure if you have it. I was very pleased with my results and they sound a lot more extensive that what you are considering.

Oh my, this seems a tad extreme to me, that said, I wish you luck should you procceed. I tend to agree with Goofproof and diver.

Same person, pending the kitty/PAP photo.

Portiemom, you have point, that any slicing off the cartilage knob might be too extreme. Would trying an alternative pillow like the Opus, LT, or Aloha be worthwhile? The knob is just at the inside entrance, so I have hesitated as any pillow would have to hit this. I tried inking up the knob and cutting the pillow to no avail. Not as sore with the Gecko pad and nasal mask, but my S9 has the unhappy red face.

I would have thought there would be more asymmetrical nostrils like mine out there!

I have more tissue (for lack of a better word) protruding in one nostril than the other, and that would frequently hurt using pillows. For some reason, it doesn't hurt with the Bella loops, even though it frequently hurts with the Swift FX with the traditional headgear. I guess the angle is slightly different, enough to make a difference with this. If the FX hurts, maybe try the Bella before you consider surgery. BTW, I'm not sure if that kind of surgery would be considered "cosmetic", and therefore out of pocket.

With the Bella loops, I had severe leaks as the loops didn't support the two different nostril positions that the FX partially does. The Pad-a-check barrel cozy seem to stabilize and hold the pillows, so I intend to re-try the Bella with the cozy.
SleepingUngly, have you tried other pillows?
Excising within the nostril shouldn't be cosmetic since you don't even see it. But I heed your advise, and wait for pre-authorization.

Well, it sounds like you and I have a slightly different problem (or severity). I don't know what mine is, but I don't know that it is cartilage per se. Yes, I've tried other pillows. I can get them to work, but in general have had to have them tighter than is comfortable.

I have slightly the same problem with the Bella Loops as one nostril is not quite even with the other, but I compensate that with lying on that side that has a small leak, and putting the pillow where the leak seems to be. I think you may want to try the Mirage FX Nasal mask, mine is the, for her, which is just the right size for me. This mask has a lightweight butterfly forehead piece that keeps the bridge of the nose from getting rubbed raw, it does for me at least. It's lightweight all over and with the kind of exhale port it has you can bury your face in the pillow if you like and when the exhale air hits the sheets or covers it doesn't seem to make a sound that will wake you. I would only do a procedure like your speaking of as a last resort. There is even a few oral masks you could try, but I've never used one, perhaps some here on the forum could speak to that. My nose does have a small classic bump from my Jewish heritage. Please keep us posted and please try some masks before you go extreme. One DME had several clinically cleaned masks and let me take several home for long periods of time to try, I did clinically clean them myself just because I was OCD about it. Best of luck my friend.

I'm using the Mirage FX nasal mask like Portiemom mentioned. If I prelube with lanolin over the bridge & tighten the PapCap more with the mask less, it's better. My Sleep Clinic had one apt to try on various small nasal masks, and none of them were as good as this Mirage FX. So I'm going to just continue to rotate between the pillows for only 2-3 nights, then the Mirage FX. Since SleepingUgly had good success with the Bellas, I'll try them again too.

Sounds like most of us have to do this mask rotation anyway, and there is no guarantee that surgery will work or not have a complication. If my AHI increases, I'll reconsider the surgery. Thanks for helping me with this decision.

I have a cartilage bump on the inner rim of my nostril
which has caused me a lot of pain off and on from nasal pillows rubbing on it. I went to the dermatologist in case it was not cartilage and he found and sliced off a hypertrophic actinic keratosis at the same spot. What are the odds of that? However the cartilage bump remains. I think I am going to consult an ENT about shaving it down. I am surprised I have found no other references to cartilage bumps besides this old thread.