Nasal valve surgery

Nasal Valve Surgery

Nasal valve collapse is a condition where the sidewalls of your nostrils collapse as you breathe in. It can occur by itself, or along with other reasons that cause nasal congestion. Typically, it occurs most often years after rhinoplasty due to weakening of the cartilages that supports the side of the nostrils. Sometimes it happens without any surgery or trauma.

One way you can tell if you have nasal valve collapse is to put your index fingers on you face next to the nostrils and pull the cheek skin away from your nose. If you can breathe much better, you may have nasal valve collapse.

A simple way of treating this problem is to use a variety of nasal dilator devices, shown below. They won’t work if your internal nose is stuffy. You can have internal nasal obstruction, or external nasal valve collapse, or both, so the best way to tell is get examined. If these dilator strips help, then it’s safe to keep using. Sometimes, it’s not strong enough, or it can irritate the skin, causing people to stop using them. Ultimately, because it is a structural problem, surgery is the only definitive way of treating this condition.

If you have allergies, a deviated nasal septum or any other intra-nasal medical condition, these issues need to be first addressed. If you have a deviated septum or some other nasal issue that does not respond to medical therapy, then surgery such as septoplasty is an option.

Specifically for valve collapse, the traditional way of treating this condition involves standard rhinoplasty techniques: alar batten graft and/or spreader grafts. Cartilage is taken from either your septum (if still there) or from your ear. It is shaped into long, thin strips. A spreader graft is placed between the septum and the upper lateral cartilage (see figure). Alar batten grafts are placed just above the lower lateral cartilage to provide support to prevent collapse of the nostrils.

A newer, lesser invasive way of treating nasal valve collapse involves using a suspension suture from the bone just underneath the eye beside the nose to the collapsing nostril area. A small incision is made in the lower eyelid and the suture is tunneled to the valve area, looped around, and tightened, thus suspending the nostril to prevent it from collapsing. A more detailed description of the procedure is published by Dr. Michael Friedman and others in the October 2004 issue of Otolaryngology - Head & Neck Surgery.