What Is Nasal Valve Collapse?
Nasal valve collapse, also known as nasal valve stenosis, is one of the most common causes of nasal obstruction. When the nasal valve, the narrow part of the airway, weakens it can collapse inward. This affects one or both sides of the nose and causes difficulty breathing. Typically, patients experience nasal valve collapse, NVC, as a result of a rhinoplasty or a deviated septum.
What Causes A Nasal Valve Collapse?
Nasal valve collapse usually occurs due to weakness or injury to the nose. This could be a traumatic injury or previous nose surgery. Additional reasons that this problem may develop include:
- Scar tissue
- Enlarged tissue
- Age-related atrophy of the nasal tissue
Signs Of Nasal Valve Collapse
Typical signs of nasal valve stenosis include nasal congestion and pronounced difficulty in breathing inward from the nose. Patients with nasal valve collapse may have a difficult time breathing during physical activities, as though they have a clothespin on their nostrils. Keep in mind, some NVC is expected during strenuous activities, but significant obstruction shouldn’t occur. These symptoms can make physical activities more difficult while for others, it may prevent them from participating altogether.
Additionally, patients may also find it especially hard to breathe while lying down, which creates a tendency to breathe through their mouth. This could result in snoring and poor sleep quality, which has further implications. Often these patients seek out remedies such as BREATHE RIGHT® nasal strips for relief, but the source of the problem remains.
Does Nasal Valve Collapse Get Worse?
The nasal valve collapse can get worse over time. This may not happen in every case, but there is a risk for the continued weakening of the nasal structure, leading to further narrowing and difficulty breathing.
How To Diagnose Nasal Valve Collapse
- Carefully review the patient’s medical history and symptoms
- Perform a nasal endoscopy which will rule out other conditions that have the same symptoms
- Conduct a Cottle Maneuver test in where the cheek is gently pulled laterally with one or two fingers to open the valve. This test determines if the most significant site of nasal obstruction is the valve or farther inside the nasal cavity
Nasal Valve Stenosis Treatment Options
For patients with nasal valve stenosis, there are few conservative treatment options. However, there are several surgical techniques our staff can use to treat NVC. The course of treatment will vary by patient and can be one of the following:
- Cartilage graft
- Nasal ridge broadening
- Permanent Sutures
“Dr. Gould and his staff were wonderful. They all took the time to answer any and all questions and made sure I was satisfied with the answers. The office is stunning! I strongly recommend St. Louis Sinus Center.”
– Leslie G.
“Dr Gould and his staff were wonderful. They were all so professional and kind. They made me feel comfortable and in good hands. I had a balloon procedure in the office…….best decision I have made in years. I would recommend them to anyone with sinus problems. I couldn’t be happier with the results.”
– Mary M.
How Can A Cartilage Graft Help A Nasal Valve Collapse?
The use of graft material is common in the treatment of nasal valve collapse. This may be referred to as a spreader or spacer that is placed to fortify the nasal structure. A spreader graft is made of cartilage. It is inserted between the septum and the upper lateral cartilage in the nasal passage.
This new structure widens the narrowed area to allow better airflow through the nasal valve. In addition to improving respiration, the cartilage graft may improve the symmetry and appearance of the nose.
How Can A Nasal Ridge Broadening Help A Nasal Valve Collapse?
The nasal ridge is the vertical line from the tip of the nose up toward the bridge of the nose, between the eyes. Using a graft, the doctor can widen this middle area of the nose, creating even more space for air to pass through the nostrils.
How Can Sutures Help A Nasal Valve Collapse?
The suture technique repairs collapsed nasal valves by securing the valve area to the bone tissue just under the eye. This connection lifts the nasal structure upward and outward to open the nasal passages for easier breathing.
The polyglycolic acid sutures that are often used for nasal valve suspension do eventually dissolve. However, studies reveal that the valve appears to remain stable over time, presumably due to the formation of submucosal scar tissue along the suture tract.
Depending on the situation, a doctor and patient may determine that it is more advantageous to use a permanent suture material rather than sutures that will dissolve. The benefit here is that there is no question about the long-term stability of the nasal valve after the suture has been inserted.
What Is LATERA?
LATERA® is an FDA approved nasal implant that provides support to the collapsing lateral nasal cartilage. LATERA can help patients breathe better by reducing nasal obstructive symptoms.
How Does LATERA Work?
LATERA is a simple procedure that Dr. Gould performs at the St. Louis Sinus Center. First, he applies topical anesthesia to ensure patient comfort. Then, Dr. Gould inserts the implant through a small, inter-nasal incision. After insertion, the implant isn’t visible and doesn’t affect the external structure of the nose. The entire procedure takes only 5 minutes.
Over the next 18 months, your body will absorb the LATERA implant. Post-implantation, a fibrous capsule begins to form and helps to maintain the integrity of the implant through 12 months. Tissue encapsulation promotes acute implant stability and enables localized tissue response during the absorption process. Once the fibrous collagen has replaced the implant remodeling is complete and the fibrous collagen will be in place to provide ongoing support.
Which Of These Treatment Options Are Right For Me?
Every situation of nasal obstruction is unique. Before recommending treatment, Dr. Gould conducts a thorough consultation and examination of the nose. This examination, which includes the Cottle Maneuver test, confirms that the cause of obstructed breathing is in fact a collapsed nasal valve and not another condition such as a deviated septum.
Which treatment is right for you may depend on your age, the severity of nasal valve collapse, and your preferences for technique, recovery, and long-term benefits. Our comprehensive consultation and discussion of treatment options should leave you with no questions about which approach would be best for you!