Treating a collapsed nasal valve with septoplasty can dramatically enhance breathing and decrease symptoms such as sinus congestion, chronic nosebleeds and snoring. This surgery addresses the source of your breathing issues – typically an irregular or bent septum – directly.
Under general or local anesthesia, your surgeon will make an incision in your nostrils to access cartilage and bone of the septum, potentially removing and reshaping them as needed.
External Valve Repair
There are various surgical approaches available for treating nasal valve collapse (or external nose obstruction). Each requires different kinds of cartilage. The best way to determine which surgical technique best fits you involves having a thorough exam of both your nostrils and nose under local anesthesia, with your ear, nose and throat doctor asking you to inhale to assess how the sidewall moves when breathing under pressure as well as inspecting septum, enlarged turbinates, sinuses and any adenoid cysts present.
Upper lateral cartilages which are weak or narrowing during inhalation can contribute to nasal valve collapse, often seen after previous nose surgery or trauma. If your lower nasal tip “deviates” into one nostril this could also increase chances of valve narrowing during inspiration.
Historically, the only treatment for this issue was to perform a cartilage graft from another part of your body like your rib or ear – an extremely invasive process which carried considerable risk while changing both appearance and airflow through nasal valves.
Recent advances in suture techniques have proven impressive without harvesting and implanting cartilage grafts, providing less invasive, faster solutions without harvesting/implanting cartilage grafts. They may be suitable for treating both static and dynamic nasal valve dysfunction; however, they are less suitable for septal perforations due to not providing large studies that compare outcomes between traditional graft techniques and suture techniques.
Dr. Kezirian was among the first surgeons to use these innovative techniques and was among the first surgeons to perform Latera and VivAer implants, which are FDA-approved treatments that support lateral nasal walls in order to alleviate dynamic nasal valve collapse.
If you are having difficulty breathing through your nose due to a collapsed nasal valve, don’t delay! Contact us immediately so Dr. Kezirian can discuss how we can help make breathing easier for you. During our appointment we will use a 4mm lighted endoscope under anesthesia to inspect all aspects that contribute to symptoms; including internal and external nasal valves, enlarged turbinates, adenoid cysts, sinuses etc.
Internal Valve Repair
If you suffer from nasal valve collapse, when breathing in, one or both nostrils narrow significantly when inhaling. It commonly affects the upper middle section of your nose and can create an ungainly appearance for you face while making breathing strips and other common breathing aids difficult to use. Your doctor can diagnose nasal valve collapse using a simple test called Cottle maneuver; pulling laterally with one or two fingers along cheek of one or both sides being evaluated opens external nasal valve while improving breathing suggests internal nasal valve has collapsed on that side of evaluation indicating collapse of internal nasal valve.
Surgery to treat a collapsed nasal valve will involve strengthening both your cartilage and fleshy sides by way of cartilage grafts taken from sources like your septum, ears or ribs or organ donors. A spreader graft may be placed between your septum and upper lateral cartilage in order to open up your internal nasal valve; while lateral crural strut grafts provide support to lower lateral cartilage for an improved internal nasal valve as well as bettering its appearance on either side of your nasal walls.
Another way to strengthen your nasal valve is with a free-floating lateral canthus batten graft, which can be installed via open or closed nasal surgery and helps increase both the external nasal valve area as well as internal nasal valve area.
Your facial plastic surgeon may recommend various surgical treatments to improve your breathing, including correcting deviated septum or enlarged turbinates, as well as non-invasive solutions like breathing strips or using breathing dilators inside nostrils to widen them temporarily. While such solutions may improve short-term, but not permanent results as effective surgical treatment would.
Sinus Surgery
Surgery may be your only recourse if nasal valve collapse and deviated septum are the source of your sinus issues. A flexible tube fitted with light and camera at its tip allows the surgeon to examine inside of your nose and sinuses using an endoscope – which allows them to pinpoint issues like deviated septum or enlarged turbinates that contributed to them causing problems – in order to make any corrections that might alleviate them.
Surgery typically entails the surgeon removing deviated parts of the septum and, in some instances, cartilage from your nose to open up more space in the middle of your nose and improve airflow. If collapse is due to severely deviated septums, cartilage from ribs or ears may also be added in order to strengthen this area; and additionally they may reduce any enlarged turbinates to help you breathe easier.
After surgery, you should expect some mild pain and pressure for up to a week after. This should resemble mild headaches but should not last. Your physician can provide medication as necessary to ease these discomforts.
Your doctor should schedule follow-up visits so they can monitor your recovery and ensure the success of your procedure. These visits also allow your physician to treat any additional symptoms such as sinusitis or persistent nasal discharge that might arise after the procedure.
As with any surgical procedure, nasal valve repair involves some risk. However, these risks tend to be minimal, and many individuals undergo successful operations with few to no complications. Your provider will go over the risks with you prior to beginning.
If your symptoms aren’t severe, your doctor may suggest trying non-surgical remedies first before opting for surgery. Non-invasive solutions for nasal valve collapse include using saline rinses or nasal sprays; sleeping with your head elevated; wearing soft nasal dilators; in some instances these medications can even prove more effective than surgery and they’re readily available over-the-counter.
Rhinoplasty
Collapsed nasal valves can restrict or completely block airflow through your nostrils, leading to chronic congestion, difficulty breathing through the nose, snoring and sleep apnea – symptoms which Jefferson Health offers various surgical solutions for in order to correct and restore normal breathing patterns. We specialize in correcting both internal and external nasal valves for normalized respiratory health.
Surgery allows us to utilize cartilage from your ear or rib as part of a graft technique to strengthen areas where nasal valve collapse is taking place, providing support against both static and dynamic nasal valve collapse. This approach has proven its efficacy for both types of valve collapse.
Opportune surgical interventions include decreasing the size of your turbinates – bony structures within your nostrils that narrow your nasal passage when breathing in. This process, known as turbinate reduction surgery, is also available as part of treatments to repair deviated septa or to perform rhinoplasty procedures.
Treatment options for collapsed nasal valves are generally very promising and most people find their symptoms are greatly improved or completely alleviated after receiving appropriate medical advice. Communicate your situation to your physician so they can tailor a tailored approach that addresses specific issues in order to formulate an effective plan of care for you.
Instead of being considered cosmetic surgery, nasal valve repair is considered medically necessary and may be covered by your insurance provider. Our doctors are experienced with numerous procedures designed to enhance nasal and sinus health, creating an enjoyable and relaxing experience that takes patients out of their doctor’s office mindset and puts them back into wellness mode.
At Jefferson Health, our multidisciplinary approach can address both sides of your nose at once by combining rhinoplasty and sinus surgery techniques for full restoration of normal breathing. As recognized by U.S. News & World Report, we utilize cutting-edge otolaryngology technologies and procedures in treating nasal issues – our team will work with you to plan a procedure suited to your unique requirements.
