Nasal Valve Collapse and Treatment

Nasal valve collapse is a breathing disorder that can result in severe nasal congestion, snoring and mouth breathing. Many doctors do not always pinpoint nasal valve collapse as the chief cause of sinus issues, so it is important that you explain all of your symptoms to your ENT or sinus specialist. You should have a list of your medications and disclose any previous nose surgeries, especially past rhinoplasties. Luckily, a variety of treatments are available to treat nasal valve collapse. Read below for an extensive host of information pertaining to the condition, and you’ll be on your way to improved breathing!

What is the nasal valve?

The nasal valve is the part of the nose that is most narrow in the nasal airway. It is found in the middle to lower part of the nose, and is comprised of four parts:

  • the anterior septum
  • lateral nasal wall
  • head of the inferior turbinate
  • osseous piriform aperture

There is often limited airflow in the nasal valve, since it is the narrowest part of the nasal airway and the valve often works to limit airflow.

nasal_valve_collapse

This diagram of  the nose pinpoints the locations of the external & internal nasal valve.

What does nasal valve collapse look like?

If you suspect you might suffer from nasal valve collapse, make an appointment with your doctor. He will give you an examination that assesses the various symptoms of the condition. For example, a “pinched” nose is one telltale sign. Your doctor might also ask you to take a deep breath and see if whether there is severe collapsing of the nasal sidewalls. An “overdone” cosmetic rhinoplasty, wherein the nose is extremely narrow, might also point to nasal valve collapse.

What is nasal valve collapse?

Nasal valve collapse is a condition that occurs when the nasal valve is weakened or narrowed. The condition is frequently noticed after a rhinoplasty since its occurrence is susceptible to any type of modification or changes to the nose’s basic structure.

Nasal valve collapse causes increased resistance when breathing, similar to the feeling of being unable to take in enough air to breathe properly.

What is the cause of nasal valve collapse?

The most commonly-encountered causes of nasal valve collapse are the following:

  • Previous cosmetic rhinoplasty procedures (including removal of a dorsal hump)
  • Nasal trauma or nasal fracture (causing inflammation, inflated tissue or excess scar tissue)
  • Congenital defect in the nasal cartilage (i.e. narrow nostrils, or a wide collumela)
  • Deviated septum
  • Aging (the aging process naturally causes weakness in the overall structure of the nose)

What are the symptoms of nasal valve collapse?

The most common symptoms of nasal valve collapse are listed below.

  • Severe nasal congestion and a pronounced difficulty in breathing out of the nose
  • Nose bleeds
  • Obstruction of the nasal and sinus passageways
  • Crust formation around the nostrils

How is nasal valve collapse diagnosed?

It is recommended that you make an appointment with a board-certified otolaryngologist (ENT) doctor to determine whether you have nasal valve collapse. To test yourself at home to find out whether you should schedule a consultation, pull up your cheek on the side where you are having difficulty breathing. If you find that you are able to breathe better as a result, you may have a nasal valve problem.

Before and after: correction of right external valve collapse (actual patient).

Nasal valve collapse is often difficult to diagnose by even the most qualified and skilled ENT doctors, because the symptoms of nasal valve collapse and other nasal breathing conditions often overlap. For example, the same symptoms associated with nasal valve collapse are also inherent in enlarged turbinates and a deviated septum.

In making a proper diagnosis, your doctor will likely ask for a detailed account of your past medical history, including any past nasal surgeries. He or she will also likely perform an examination of the nose, via a nasal endoscopy, whereby he or she uses a device called a nasal endoscope to look into the nasal cavities and pinpoint any problems. For some patients, your doctor may perform an acoustic rhinometry, whereby sound waves are used to determine whether the nasal cavity has recently undergone any changes.

How is nasal valve collapse treated?

nasal valve collape

Before and after: Correction of bilateral internal valve collapse due to a previous cosmetic rhinoplasty. Note the ‘inverted-V’ shape of the nasal bones on the left (actual patient).

Treatment No. 1 – Nasal Valve Surgery The majority of patients who are diagnosed with nasal valve collapse elect for surgery to permanently correct their symptoms. During surgery, your doctor rebuilds your nose to give it more structural support. Most often, cartilage grafting in both the internal and external nasal valves, called an alar batten graft, is needed to create this stability. Overall, doctors and medical researchers agree that surgery is the most popular and most effective treatment option for nasal valve collapse.

Note: Since nasal valve collapse can negatively affect your health, surgery to correct this condition is not considered elective or cosmetic. As a result, your insurance carrier is likely to cover the costs of surgery, leaving you with little to no out-of-pocket costs depending on your individual policy.

Treatment No. 2 – Nasal Valve Dilator – A small percentage of patients sometimes opt for treatment via a nasal valve dilator. This mechanism, primarily worn at night, helps to manually widen most commonly sold in the form of Breathe Right strips, which are also worn by athletes and sufferers of sleep apnea.

Treatment No. 3 – Rhinoplasty – Rhinoplasty (with or without grafts) is another option for those with nasal valve collapse. Rhinoplasty with or without the use of grafts is frequently used to repair nasal valve collapse.

Treatment No. 4 – Implants –  In addition, your surgeon may choose to use implants inside the nasal valve that serve to prevent future collapse. These implants are made of titanium and are often used if there is evidence of severe collapse. Patients who have previously undergone a rhinoplasty and several revision rhinoplasties are candidates for implants, since there is a greater likelihood of a “pinched” or extremely narrow-looking nose.

If you have a functional problem like nasal valve collapse, make an appointment with your ENT as soon as possible. He or she will determine the best treatment method, and you can begin to take steps to restore your breathing back to normal. Remember that this condition is one of the most over-looked causes of nasal airflow obstruction, so don’t forget to provide an exhaustive list of symptoms.

breathing easy

Many patients’ have improved breathing ability from nasal valve collapse surgery.

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