Diagnosing and Treating Nasal Valve Collapse

What exactly are the Nasal Valves?

Illustration of nose and nasal valves On each side of the nose, there are two nasal valves: one internal and one external. These valves are located in the middle and lower portions of the nose, at the narrowest section of the airway.

Typically, the airflow is limited in the nasal valves. Limited airflow is actually desired so that the air you breathe can be warmed and purified. However, if nasal valve collapse occurs, it can cause increased resistance, making breathing difficult. In most cases, collapse occurs in the internal nasal valves. However, the external valves can be affected, as well.

How does a Nasal Valve Collapse occur?

A collapse is characterized by a weakening of the nasal valve. The most common causes of this condition include:

• Nasal trauma or fracture, which can lead to inflammation or scar tissue
• A congenital defect in the cartilage of the nose
• Previous rhinoplasty (nose job) procedures
• A deviated septum
• Decreased bone density due to the natural aging process

Signs & Symptoms

The most common symptoms of nasal valve collapse include general feelings of stuffiness, and the inability to breathe fully. This can affect one or both nostrils. Patients experiencing these symptoms may find temporary relief from breathing strips, as they lift the soft tissues and expand the airway. This solution will not provide a lasting improvement, however, and you will eventually need to be treated by a professional.

It can be difficult to diagnose nasal valve collapse because the symptoms often overlap with other conditions, such as a deviated septum or enlarged turbinates. An ENT, like the specialists at Chesapeake Ear Nose & Throat, will need to perform a thorough assessment to determine the exact cause.

It can be difficult to diagnose nasal valve collapse, so it is important to choose a highly trained specialist for your treatment.

Methods for diagnosing Nasal Valve Collapse

One of our physicians or a trusted specialist will examine your nose, throat, and medical history to properly diagnose nasal valve collapse as a cause of your symptoms. The diagnosis can be difficult because other conditions, such as an enlarged turbinate or deviated septum, can cause similar symptoms. During the examination, one of our doctors may use any of the following techniques to determine if you are experiencing a nasal valve collapse.

• Endoscopy: An endoscope is inserted the mouth or nose to view the affected area.
• Cottle’s maneuver: The nasal valve is manually widened by pulling it in a lateral direction. If the maneuver leads to improved breathing, it is an indication of nasal valve collapse.
• Nasal decongestant drops: The effectiveness or ineffectiveness of decongestant drops can point toward nasal valve collapse.
• Acoustic rhinometry: This procedure uses sound waves to measure changes in the nasal cavity.
• Anterior rhinomanometry: This diagnostic procedure measures nasal airway resistance and resulting airflow.

Treatment options for internal Nasal Valve Collapse

The treatment recommended for nasal valve collapse will largely depend on the cause. For example, if the obstruction is primarily the result of tissue inflammation, the condition can often be treated non-surgically with anti-inflammatory agents and antibiotics.

Spreader Grafts

If the airway obstruction is due to physical abnormalities, you may require surgical intervention. The internal nasal valves can be augmented using a spreader graft, which is placed between the upper lateral cartilage and the septum to correct the problem. In contrast, an external valve collapse can typically be addressed with an oval-shaped alar batten graft. The graft is placed at the weakest portion of the lower lateral cartilages to fortify the nasal airway. The grafting material can be taken from ear, rib, or septal cartilage. Many doctors prefer the results which can be obtained from conchal (ear) cartilage because of its curved shape.

Spreader grafts are often the most effective at treating nasal valve collapse in the middle vault of the nose. The middle vault refers to the middle third of the nasal bridge that is above the nasal tip and below the nasal bones.

Nasal Valve Dilators

Another treatment option is a nasal valve dilator, which is typically worn at night. Breathe Right strips are one popular example of this treatment option. The adhesive strips stick to the outside of the nose and widen the area around the nasal valve. Some dilators are available over-the-counter while others are custom made from silicon and worn internally.

Rhinoplasty Surgery

Finally, rhinoplasty with or without the use of grafts can be an effective treatment for nasal valve collapse.

Treatments for external Nasal Valve Collapse

The external nasal valve is the bottom “tip” of your nose. Patients suffering from an external nasal valve often report that the tip of their nose feels pinched. An alar batten graft can be placed during either an open or closed rhinoplasty. The graft is sutured directly to the area that needs support. Swelling from the procedure may last for a few months. O

ne question patients often ask about this procedure is if the grafts will be visible after they are placed. The grafts are minimally visible because they are placed deep under the skin at the sides of the nose. Because they are made from cartilage, they will match the feel and texture of the surrounding nasal area. The grafts can improve breathing and the function of the nose and can even repair the effects of an obvious or unnatural-looking rhinoplasty.

Schedule a Consultation

If you are experiencing breathing difficulties in one or both nostrils, consider scheduling an appointment with one of our specialists. We can help determine the cause of your condition, and begin developing a fully personalized treatment plan to meet your needs. To reach our practice, contact us using our online form or call (410) 391-1118.