Breathing effortlessly through your nose is something many take for granted. However, for those experiencing nasal valve collapse, simple tasks like inhaling can become challenging. Nasal valve collapse is a prevalent yet often overlooked cause of nasal obstruction, leading to significant discomfort and impacting the quality of life. In this article Dr Turner will outline what nasal valve collapse is, how to identify it, and the treatment options available to improve the symptoms of nasal valve collapse.
What Are the Nasal Valves?
The nasal valves are critical structures within the nose that regulate airflow during breathing. They are the narrowest parts of the nasal airway and play a pivotal role in controlling the resistance to airflow.
Internal Nasal Valve
The internal nasal valve is located deep within the nasal cavity. It is formed by the junction of the septum (the wall dividing the two nasal passages), the upper lateral cartilage (along the middle part of the nasal dorsum), and the floor of the nasal cavity. This valve is responsible for most of the airflow resistance within the nose. Even minor changes or abnormalities in this area can significantly impact breathing efficiency.
External Nasal Valve
The external nasal valve is situated at the nostril’s entrance. It comprises the lower lateral cartilage (alar rim), the nasal septum (columella), and the nasal floor. This valve primarily functions during deep inhalation or heavy breathing, such as during exercise. Any deformities or weaknesses here can lead to external nasal valve collapse, further impeding airflow.
How to Tell If I Have Nasal Valve Collapse?
Identifying nasal valve collapse can be challenging, as its symptoms often mimic other nasal conditions like allergies or sinusitis. However, certain signs and tests can help determine if you’re experiencing this condition.
Nasal Valve Collapse Symptoms
- Persistent Nasal Congestion: A constant feeling of stuffiness in one or both nostrils that doesn’t improve with typical decongestants or allergy medications.
- Difficulty Breathing Through the Nose: Struggling to inhale, especially during physical activity or when lying down.
- Nasal Obstruction Sensation: Feeling as if something is blocking your nasal passages, leading to mouth breathing.
- Snoring or Sleep Disturbances: Impaired airflow can contribute to snoring or conditions like sleep apnoea.
- Nasal Whistling or Noisy Breathing: A high-pitched sound during inhalation due to airflow through a narrowed passage.
- Visible Collapse of the Nasal Sidewalls: Observing the nostrils narrowing or collapsing inward during inhalation.
Nasal Valve Collapse Test: The Cottle Manoeuvre
One simple way to perform a nasal valve collapse test at home is the Cottle Manoeuvre:
- Place two fingers on your cheeks, on either side of your nose.
- Gently pull your cheeks outward, away from your nose.
- Breathe in through your nose.
- If you notice an improvement in your breathing, it may indicate nasal valve collapse.
Causes of Nasal Valve Collapse
Understanding what leads to nasal valve collapse can aid in prevention and treatment planning
Trauma
Trauma to the nose is a common cause of nasal valve collapse. Nasal injuries can compromise the structural integrity of the nasal cartilage and bones. This damage can disrupt the normal anatomy of the nasal valves, leading to obstruction and breathing difficulties. Additionally, previous rhinoplasty surgery, can contribute to nasal valve collapse. Over-resection of cartilage during these surgeries may weaken the support structures of the nose, increasing the risk of valve dysfunction.
Congenital Factors
Some individuals are born with structural weaknesses in their nasal cartilage, making them more susceptible to nasal valve collapse leading to breathing difficulties even without any trauma or prior surgeries. Additionally, anatomical variations such as a deviated septum or enlarged turbinates can contribute significantly to airflow obstruction. A deviated septum, where the nasal septum is displaced to one side, narrows the nasal passage and increases resistance to airflow. While enlarged turbinates, can become swollen and obstruct the nasal airway, exacerbating the symptoms of nasal valve collapse.
Inflammatory Conditions
Chronic allergic rhinitis plays a significant role in the development of nasal valve dysfunction. Persistent allergic reactions cause continuous swelling and ongoing inflammation of the nasal passages, which can alter nasal structures over time. This persistent inflammation leads to swelling and thickening of the nasal tissues and weakening the support structures of the nasal valves, increasing the risk of nasal valve collapse.
Treatment Options for Nasal Valve Collapse
Treating nasal valve collapse aims to restore normal airflow through the nasal passages. The choice between non-surgical and surgical options depends on the severity of the collapse and its impact on your quality of life.
Non-Surgical Treatments
Non-surgical approaches focus on alleviating symptoms and improving nasal airflow without invasive procedures. Nasal dilators, such as external adhesive strips applied across the nose and internal nasal cones inserted into the nostrils, mechanically widen the nasal passages to prevent collapse during breathing. Medications play a role in reducing nasal obstruction; nasal corticosteroids decrease inflammation within the nasal passages, while antihistamines manage allergy symptoms that can exacerbate congestion. Lifestyle modifications also contribute to symptom relief—avoiding irritants like smoke and pollutants reduces nasal inflammation, using humidifiers keeps the nasal passages moist to prevent dryness and irritation, and regular nasal irrigation with saline sprays or rinses clears mucus and allergens, promoting better airflow.
Surgical Treatments
When non-surgical methods are insufficient to alleviate the symptoms of nasal valve collapse, surgical intervention may be necessary to correct the structural issues causing obstruction. These treatments aim to restore proper nasal function and can also enhance the aesthetic appearance of the nose. The choice of procedure depends on the specific anatomical problems contributing to the collapse.
Functional Rhinoplasty
Functional rhinoplasty focuses on improving nasal airflow and function, with potential cosmetic benefits. It addresses structural problems contributing to nasal valve collapse by reinforcing and reshaping nasal anatomy.
One key technique is the insertion of spreader grafts, thin strips of cartilage placed between the septum and upper lateral cartilages. This widens the internal nasal valve, significantly enhancing airflow. Alar batten grafts support the external nasal valve by reinforcing the nostril sidewalls, preventing them from collapsing inward during inhalation. Flaring suture techniques adjust the positioning of nasal cartilages through precise suturing, enhancing valve function without additional grafts.
Dr. Turner tailors these procedures to each patient’s anatomy, ensuring functional issues are effectively addressed while considering aesthetic preferences, resulting in improved breathing and satisfaction with nasal appearance.
Septoplasty
A septoplasty corrects a deviated septum, a common contributor to nasal valve collapse and breathing difficulties. By repositioning the deviated septum and removing or reshaping excess bone or cartilage, airflow is enhanced, alleviating symptoms like nasal congestion, obstruction, snoring, and sleep apnea. Septoplasty often complements other nasal surgeries like functional rhinoplasty, providing a comprehensive solution to airway problems.
Revision Rhinoplasty
Revision rhinoplasty addresses issues from previous nasal surgeries that led to nasal valve collapse. It involves correcting challenges posed by scar tissue, altered anatomy, and weakened structural support. The surgeon may reconstruct and strengthen the nasal framework using cartilage grafts, with techniques like spreader and alar batten grafts. This complex procedure demands high expertise due to its intricacies. Dr. Turner specializes in revision rhinoplasty, utilizing advanced techniques to meticulously reconstruct and reinforce nasal structures compromised by prior surgeries.
Next Steps
An accurate diagnosis of nasal valve collapse requires formal evaluation by a Specialists Plastic or ENT Surgeon like Dr. Turner, who can provide a comprehensive assessment and treatment plan.
- Schedule a Consultation: Reach out to drturner.com.au to book an appointment.
- Prepare for Surgery: Follow any preoperative guidelines provided, such as avoiding certain medications and arranging for post-surgery care.
- Plan for Recovery: Set aside time for rest and healing. Arrange for assistance if needed during the initial recovery phase.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Consult with a qualified healthcare professional to determine the best treatment options for your individual needs.
