If your nasal valve collapses, you could experience symptoms like congestion, snoring and nosebleeds. Seek medical assistance immediately from an ENT specialist so they can assess and provide appropriate diagnosis.
Internal or external nasal valve collapse may be caused by factors like rhinoplasty that weakens the septum or deviated cartilage, age-related changes or injuries to supporting tissues of your nasal valve, as well as age or injury-related problems.
Turbinate Reduction
Your nose is an integral component of breathing; it warms, humidifies, and filters air that travels through it before reaching your lungs. When nasal valve collapse occurs, symptoms include difficulty with exercise breathing, mouth breathing issues, persistent sinusitis issues and chronic congestion issues. If you suspect you have collapsed nasal valve, an otolaryngologist may conduct the Cottle test; during this simple examination they’ll pull one cheek as you take an inhale and observe whether one nostril opens when breathing improves; if this side then collapse exists on that side of your nose – then it indicates collapse is present on that side of your nose.
Deviated septum is often at the root of collapsed nasal valves. This condition affects your nostril’s cartilage foundation, and can result from trauma, surgery or birth defects – though older adults are particularly prone to it due to natural aging processes.
Turbinate hypertrophy, otherwise known as enlarged turbinates, can also contribute to nasal valve collapse. Swollen turbinates create pressure and congestion which makes breathing difficult; allergies, nasal obstruction, or surgical interventions can exacerbate this condition, while often accompanying other issues affecting the nose like deviated septum or swollen lateral nasal cartilages.
Bella Vista ENT’s otolaryngologists may recommend minimally invasive surgery called Turbinate Reduction as an option to help alleviate symptoms associated with collapsed nasal valves and swollen turbinates. An anesthetic will be administered during this in-office procedure, using it to shrink your swollen turbinates quickly and painlessly – providing years of effective relief from their symptoms.
There are a number of effective turbinate reduction techniques, each one differing in effectiveness and duration. Vivear and Latera use radiofrequency energy to stiffen nostrils without needing to remove bone or tissue; both procedures take only 15 minutes under IV sedation in an office setting. More involved surgeries utilizing cartilage from either nose or ear require up to an hour at a surgical center and patients can expect their nose or ears to feel stuffy for several days to weeks post procedure; taking anti-inflammatories such as aspirin may increase bleeding.
Alar Batten Grafting
Alar strut or batten graft is an effective treatment option for several pathologies in the middle third of the nose, including boxy nasal tips, lateral crural retraction/collapse and concave lateral crura. The graft is inserted between septum and upper lateral cartilages using multiple sutures; providing structural support while simultaneously improving nasal valve function as well as having cosmetic effects on nasal dorsum/tip and correcting an overly pinched tip.
Grafts are typically composed of septal or ear cartilage; however, occasionally small pieces of bone may also be utilized. Proper placement of this graft is key to its successful implementation: too deep an insertion can weaken existing septal cartilage while too close insertion may create airway obstruction, potentially creating airway blockages when placed too closely to existing septal cartilage and placed with too much tension.
Some clinicians criticize the use of septal grafts in patients with preexisting septal deviation, fearing that its placement will further restrict internal nasal passageway. While such concerns are valid, critics often support less-invasive techniques like retraction and rotation maneuvers to correct defects with lower lateral cartilage resection – these techniques do not carry as high of risk for weakening septal cartilage or leading to complaints in external nasal valve areas.
Spreader grafts were once considered the go-to solution for middle nasal vault reconstruction, but have fallen out of favour due to limited functional benefits and adverse aesthetic results. New solutions have emerged such as turn-in and onlay spreader grafts – modifications of standard spreader grafts designed to better lateralize nasal sidewalls while opening nasal valve angles by rotating upper lateral cartilages – as alternatives.
Latera® Implants
Your nose plays an essential part of airflow process; it warms, humidifies and filters air before entering your lungs – an essential function to protecting health. Unfortunately, sometimes internal nasal valves narrow restricting airflow resulting in congestion or sinusitis symptoms. If other treatment methods don’t help our team can offer an absorbable nasal implant called LATERA to correct collapsing nasal valves which supports upper and lower lateral cartilage on nasal walls to help avoid collapsed valves, reduce symptoms associated with nasal obstruction symptoms while improving cosmetic appearances of noses as a whole.
Your provider can perform the procedure at our office under local anesthetic. They will insert a cannula into each nostril, and release an implant via this tube into position. The implant will anchor itself above your maxilla bone to prevent collapsed areas from widening too much; eventually it will be fully absorbed by your body within 18 months; providing support without negatively affecting structural stability in your nose.
Bioabsorbable implants stimulate natural collagen formation to provide long-term support for your nasal structure and avoid further collapsed nasal valves. This procedure has an impressive track record of success and is an ideal option if you suffer from dynamically collapsed nasal valves that cannot be corrected with traditional turbinate reduction or alar batten grafting procedures.
This study shows that in-office treatment with an absorbable nasal implant to support upper and lower lateral nasal walls significantly improves quality of life for those suffering from dynamic nasal valve stenosis.
We have helped many patients overcome this condition, enabling them to breathe normally and more fully enjoy life. If this problem is hindering you, contact our New York City office or fill out the contact form on this page and schedule a consultation today – either way!
Sutures
If your nasal valve collapses, breathing becomes compromised as its airway has narrowed. Unfortunately, this condition will not improve without treatment; fortunately there are surgical techniques available that can restore breathing capacity.
Nose surgeons offer several techniques for correcting collapsed nasal valves. One such approach is nasal valve suspension; this involves linking tissue from inside your nose with tissue underneath your eyeball in order to lift and widen it.
Other surgical techniques involve supporting collapsing tissue with cartilage or bone grafts taken from other parts of your body such as your ear or rib and transplanted into your nose to increase structural support. Such procedures include alar batten graft and lateral crural strut graft procedures.
Cottle test: an effective surgical way of opening your nasal passages This examination allows your doctor to detect whether one or two nasal valves are restricted, by pushing laterally on one or both nostrils during inhalation and applying pressure laterally with one or both fingers, pressing laterally against an evaluated nostril with 1 or 2 fingers as you inhale; if breathing becomes easier on that side then collapsed nasal valve is likely responsible.
Tensile strength of sutures (their ability to be pulled apart without breaking) and composition are two elements that determine surgical success. Modern suture materials range from #5 (heavy braided sutures used in orthopedics) to #11-0 (fine monofilament sutures for ophthalmics); selection depends on tissue and needle needs.
Breathing strips or internal nasal dilators may temporarily improve symptoms associated with a collapsed nasal valve; however, these remedies won’t resolve the underlying problem and may leave visible marks on your nose. For optimal results it’s best to have an experienced nasal surgeon address the collapsed nasal valve through surgery; Dr. Mobley has spent decades honing his techniques for doing just this and has published many articles and book chapters related to his expertise on this subject matter.
