Nasal (Luminal) Valve Obstruction is the collapse or narrowing of the nasal valve, also known as vestibular stenosis, an important and often overlooked cause of chronic nasal obstruction. The internal nasal valve is located in the anterior portion of the nose just above the opening and is described as the area between the septum (the center wall of the nose) and the cartilage of the nasal sidewalls. The nasal valve plays an important role in airflow through the nose. Because the cross-sectional diameter of the nose is naturally the smallest in this area, even minor changes can significantly impact airflow. It is not uncommon for the valve to collapse during vigorous breathing (likely to occur with strenuous exercise), but collapse during normal inhalation is an abnormality that can result in significant problems and discomfort.
Symptoms and Complications of Nasal (Luminal) Valve Obstruction or Collapse
- Nasal obstruction: When the nasal valve collapses, it obstructs the nasal airway and prevents proper airflow. This can occur on one or both sides of the nose.
- Snoring: The inability to inhale a sufficient volume of air through the nose while sleeping may result in snoring and other sleep disruptions.
- Mouth breathing: Individuals who suffer from nasal valve collapse are often forced to compensate by breathing through their mouths.
Causes of Nasal Valve Collapse
- Previous rhinoplasty: The most common cause of nasal valve collapse is a weakness or narrowing of the area due to past surgery. Rhinoplasty to reduce the cross section of the nose and the external appearance can result in this condition.
- Inherent weakness: For some individuals, a structural weakness of the nasal valve is present at birth. This weakness causes the valve to collapse during inhalation, and full airflow is inhibited.
- Deviated septum: The displacement of the septum can significantly narrow one side of the nasal valve.
- Aging: The natural aging process can result in structural changes and weakening of the nasal valve.
- Trauma: Trauma to the nose can alter the angle and functionality of the nasal valve on one or both sides of the nose.
Treatment and Diagnosis of Nasal Valve Collapse
Proper diagnosis of nasal valve collapse is essential. Unfortunately it is often missed or not diagnosed until other treatments and even surgeries have failed. The condition is characterized by the collapse of one or both sidewalls during inspiration, but symptoms can be similar to other nasal obstructions. Once the correct diagnosis is made proper treatments can be recommended.
Nasal strips: Adhesive strips, such as Breathe Right Strips, use spring-like bands to help pull open the nasal valve. They are placed externally across the nose. When the bands attempt to straighten, the sides of the nose are lifted and the nasal valve is opened. These strips a can be especially helpful during sleep and exercise, but are only a temporarily solution.
Stents: Basket like stents can be placed inside the nose to reinforce and hold open the nasal valve.
Surgery: Surgery is typically the only permanent treatment for nasal valve collapse. A number of techniques are available and results can vary greatly.
Surgical Correction of Nasal Valve Collapse
The purpose of nasal valve surgery, regardless of the method, is to restore support to this area of the nose. Nasal valve collapse is a complex condition and successful repair requires the surgeon to find the technique that will best fit each individual patient. This may depend on a number of factors including the cause and severity of the stenosis. One technique involves the use of spreader grafts made from cartilage. The grafts are placed between the upper lateral cartilage and the septum to widen the nasal valve angle and support the valve structure. It is common for this form of rhinoplasty to alter the external appearance of the nose to some degree. Newer, minimally invasive procedures are gaining popularity and have less of an impact on the appearance of the nose. These techniques attempt to reshape the nostrils using sutures or screws to suspend the nasal tissues. These surgical procedures can all be done under general or local anesthesia depending on patient and surgeon preferences. Recovery time depends on the surgical technique used and the complexity of the surgery.