Causes and Treatment of Nasal Valve Collapse

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Nasal valve collapse is a term that refers to any weakness or further narrowing of the nasal valve. Since the nasal valve is such a narrow area anyway, any alteration in the structure of the nose which affects this area can result in increased resistance or even block airflow.

Woman with bandaged nose
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The nasal airway is difficult to explain, anatomically, since it is not made up of only one structure but several structures, including the:

  • Lateral nasal wall
  • Anterior septum
  • Head of the inferior turbinate
  • Osseous piriform aperture

This complicated description probably means little you, and it means even less when you realize that individual nasal anatomy varies greatly.

If you think of the exterior nasal structure, it may be helpful to know that the nasal valve is located in the middle-to-lower portion of the nose.

Because this is the narrowest part of the nasal airway, there is a great deal of air flow resistance that occurs in this area and the nasal valve actually works to limit airflow.

Causes

Trauma or surgery to the nose are common causes of nasal valve collapse. Causes include:

  • Rhinoplasty (plastic surgery to the nose), including "hump removal," is one of the most common causes.
  • Deviated septum is a very common cause of nasal valve collapse. A deviated septum frequently occurs as the result of trauma (injury) to the nose.
  • Trauma or nose surgery can cause nasal valve collapse as a result of inflammation, enlarged tissue, or possibly the formation of scar tissue.

Nasal valve collapse can occur without any trauma or history of surgery to the nose and can actually be the result of certain inherited anatomical characteristics.

For example, an over-projecting nose and narrow nostrils or wide columella (an exterior portion of the nose that separates the two nostrils). Other congenital conditions may also result in nasal valve collapse.

You may be more likely to develop nasal valve collapse as you get older since the natural aging process may naturally weaken the structures which make up the nasal valve.

Symptoms

Symptoms of nasal valve collapse include:

  • Nasal obstruction
  • Congestion and difficulty breathing from the nose
  • Bloody nose
  • Crusting around the nostrils

Diagnosis

An otolaryngologist (ENT) doctor is probably best qualified to diagnose nasal valve collapse.

It's a difficult diagnosis to make, especially since enlarged turbinates and deviated septums cause the same symptoms and may be overlapping conditions. Your medical history can be important in obtaining a diagnosis, particularly if you have had a history of nasal surgeries.

Examination of the nose and any of the following may help in appropriately diagnosing nasal valve collapse:

Several more complicated tests may be done as well, such as:

  • Cottle's maneuver: The nasal valve area is widened by pulling it in a lateral direction. If breathing improves when the nasal valve area is manually widened, it is an indication of nasal valve collapse.
  • Bachman's maneuver: The nasal valve is widened using instruments and then improvements in breathing are assessed.
  • Anterior rhinomanometry: You sit upright and blow your nose while a pressure-sensing tube in one nostril measures nasal airflow.
  • Acoustic rhinometry: Sound waves are used to assess changes in the nasal cavity.

Treatments

The most common treatment for nasal valve collapse is surgery. However, those who do not wish to have surgery or wish to delay surgery may find some relief of symptoms by using a nasal valve dilator.

A nasal valve dilator is a device that manually widens the nasal valve. It is usually worn at night.

One example of a nasal valve dilator is Breathe Right strips which are adhesive strips that are stuck to the outside of the nose and serve to widen the nose at the area of the nasal valve.

This type of nasal valve dilator is available over-the-counter. Other dilators are made of silicone and are worn internally.

It should be noted, however, that the use of nasal valve dilators as a therapy or treatment for nasal valve collapse has not been adequately studied at this time.

Rhinoplasty with or without the use of grafts is frequently used to repair nasal valve collapse.

Sometimes titanium implants are used which hold the nasal aperture open by "spring effect." Multiple surgical techniques exist as well and the technique used varies depending on your surgeon and your particular situation.

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