Nasal Valve Collapse Surgery in NYC & NJ
Nasal valve collapse is the most commonly missed diagnosis in patients with persistent nasal obstruction. This is especially true in patients who fail allergy treatment or do not experience relief after deviated septum surgery. The nose is a complicated organ with many structural parts that determine the shape and function of our nose. The patency of the external and internal nasal valves determines the resistance to airflow as we breathe. Dr. Tadros specializes in nasal valve collapse surgery for her patients in NYC & NJ.
Nasal Valve Collapse In Depth
by Monica Tadros, M.D., F.A.C.S.
Nasal valve collapse also known as vestibular stenosis refers to the loss of cartilage support that keeps the sidewalls of the nose open during breathing.
The internal and external nasal valves are defined by the lateral nasal walls. These sidewalls (the lower and upper lateral cartilages) can be thought of like the roof of a house in relation to the supporting beams (the septum).
The external nasal valve involves the lower third of the nose and is formed by the alar subunit (the rim of soft tissue surrounding our nostrils). During inhalation, the nasalis muscle expands the external valve and can be tested by flaring your nostrils.
The internal nasal valve involves the middle third of the nose and lies deep within the nose. The internal nasal valve is responsible for most of the resistance to airflow in the nose. The angle between the upper lateral cartilage and septum is normally 15 degrees. So even a small decrease in this angle can cause a significant breathing problem.
What Causes Nasal Valve Collapse?
Anything that decreases support to the tip of the nose can lead to nasal valve collapse. The most common cause of nasal valve collapse is trauma. Most commonly this is from an undetected cartilage fracture of the nose or from prior reduction rhinoplasty surgery. Aging can also lead to progressive weakness, droopy tip heaviness and narrowing of the nasal valves. Nasal valve collapse may be fixed or dynamic. Patients with dynamic nasal valve collapse may only notice symptoms during exercise or sleep.
How Can Nasal Valve Collapse Be Treated?
Patients who find some relief from Breathe Right strips should be evaluated for nasal valve collapse. Breathe Right strips stent the sidewalls of the nose in a more open position. This widens the internal nasal valve and decreases resistance during breathing.
Patients who suffer from nasal valve collapse often have other nasal abnormalities, including hypertrophic turbinates and sinusitis due to poor circulation of air in the nose and sinuses. Surgical correction of nasal valve collapse involves using cartilage grafts to restore support to the nasal sidewalls. The internal nasal valve is treated with spreader grafts or onlay grafts placed in the middle nasal vault. The external nasal valve is treated with alar batten grafts, lateral crural strut grafts or columellar strut grafts to restore the lower third. In some cases minimally invasive suture techniques can be used without cartilage grafts to widen the nasal valve.