Overcoming Nasal Valve Collapse - Easing Breathing

Creator: Dr. Dharmashree. R. D
Published: 2023-05-03T13:13:21

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Weakness or narrowing of the nasal valve is known as nasal valve collapse. Read the article below to know more about it.

Written by

Dr. Dharmashree. R. D

Medically reviewed by

Dr. Akshay. B. K.

May 3, 2023

August 21, 2023

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Contents

What Is Nasal Valve Collapse?
What Are the Types of NVC?
What Are the Causes of NVC?
What Are the Symptoms of NVC?
How to Diagnose NVC?
How to Treat NVC?

Introduction

The nasal valve is the very narrowest space in the nasal airway. Further narrowing or weakness of the nasal valve leads to increased resistance or may completely block the airflow. The nasal valve is located in the middle to lower portion of the nose. Air flow resistance occurs in this area. The function of the nasal valve is to limit the airflow. Alteration of structures present in this area may lead to resistance or blockage of airflow.

What Is Nasal Valve Collapse?

Nasal valve collapse (NVC) is otherwise known as nasal valve stenosis. The nasal valve helps maintain airflow in the nose. Narrowing of the nasal valve or when it weakens, it may collapse inwards, obstructing the airflow. It may involve one side or both sides of the nasal cavity.

What Are the Types of NVC?

The nasal airway consists of structures such as;

Lateral nasal valve.
Anterior septum.
Head or anterior face of the inferior turbinate.
Osseous piriform aperture.

The nasal valve is divided into two parts and there are two types of NVC:

Internal NVC: Obstruction of nasal airway occurring halfway up the nose.
External NVC: Obstruction of airway occurring due to collapse of nostrils.

What Are the Causes of NVC?

NVC may occur due to trauma or surgery done to the nose. Other causes include;

Scar Tissue: Collection of cells and collagen that covers the site of an injury.
Inflammation: The process by which the immune system recognizes and removes harmful and foreign stimuli and begins the healing process. It is a part of the body’s defense mechanism.
Changes In The Tissue: When there is an increase in the size of the tissue, NVC is experienced.
Deviated Nasal Septum: It occurs when cartilage and bone separating the nasal cavity are not straight.
Rhinoplasty: A nasal surgery that may cause the weakening of the cartilage.
Congenital Malformations: These include the projected nose, narrow nostrils, and wide columella (the part that separates two nostrils).
Age: Growing age may weaken the nasal valve.

What Are the Symptoms of NVC?

NVC shows many symptoms like difficulty in breathing as a main problem. Other symptoms include

Congestion of the nose.
Obstruction in the nasal path.
Bleeding from the nose.
Nostrils get crusted.
Snoring while sleeping.

Gradually symptoms may get worse but may vary among individuals, depending on the cause and severity of NVC. It is always a risk of weakening structures leading to further narrowing of the nasal airway which results in difficulty in breathing.

These symptoms are graded based on a scale. Nasal obstruction symptom evaluation (NOSE) scores. This helps to know the degree that an individual experiences nasal congestion, blocked nasal passages, and trouble breathing and sleeping, especially during exercise.

How to Diagnose NVC?

Correct diagnosis helps in the appropriate treatment of NVC. The following tests are to be done to diagnose;

Medical Examination: A thorough medical examination that includes history and symptoms to be done.
Nasal Endoscopy: This procedure is recommended to rule out other reasons for NVC.
Cottle Maneuver Test: This test determines whether the site involved is a nasal valve or deep inside the nasal cavity. When nasal valve space is widened by pulling laterally, if the airway improves, it means that nasal valve collapse is present.
Bachman’s Maneuver: In this test, the nasal valve is widened using instruments, then checked for improvement in breathing.
Anterior Rhinometry: This procedure is done by making the individual sit upright and asking to blow through the nose. During the same time, the pressure-sensing tube is kept in one of the nostrils and will measure the airflow in the nose.
Acoustic Rhinometry: Sound Waves are used to measure changes in the nasal cavity.

How to Treat NVC?

There are many methods to treat NVC by which one can achieve relief from the problem. These include;

1. Surgery: The common approach to treat NVC is surgery of the nose. It is done by placing a cartilage graft. This graft has to be taken by other parts of the body from the individual and placed in the nasal valve to reconstruct the structure lost. The Alar Batten grafting approach is the common surgical approach in which cartilage or bone (thin piece) is placed in the nasal valve. Apart from placing the tissues, other issues, like factors that cause collapse, need to be taken care of by the surgeons. The procedures involved are;

Septoplasty: In this procedure, the deviated nasal septum is corrected by repairing or repositioning the nasal septum. Cartilage removed during this procedure may be used to strengthen the nasal valve.
Turbinate Reduction: In this procedure, turbinate present in the nasal valve are reduced in size or removed as they will obstruct the airway.
A newer method is placing an implant instead of a tissue. These implants help in reducing the symptoms and help maintain the shape of the valve.
Nasal Ridge Broadening: Nasal ridge is the vertical line from the tip of the nose to the bridge of the nose. Using a graft widening the middle area of the nose is done to improve the airway.
Sutures: This procedure helps in increasing the area upward by securing the valve area to the bone tissue under the eye.

2. Nasal Decongestants: These are non-surgical approaches used to widen the nasal airway. Nasal decongestants, which contain pseudoephedrine, decrease the swelling in the nose and help in breathing normally.

3. Nasal Valve Dilators: The dilators are generally worn at night and open up the valve manually. Breathe right strips, an over-the-counter option, are adhesive strips that stretch the outer skin of the nose, thereby increasing the space for the airway. Silicone dilators are worn internally.

Conclusion:

The nose is an important sense organ used to live by breathing through it. If any difficulty in breathing occurs, individuals face discomfort and fail to carry out the work normally in day-to-day life. NVC is not a serious condition but still poses many problems. Hence it should not be neglected. Knowing in detail about this condition helps one to seek medical help at the earliest. Early diagnosis helps in the effective treatment of the condition which will also help in achieving good quality of life.

Frequently Asked Questions

1. What Are the Treatment Options for Nasal Stenosis?

Treatment options for nasal stenosis typically involve a multifaceted approach to alleviate symptoms and improve nasal airflow. Non-surgical treatments may include nasal decongestants, saline sprays, nasal dilator strips, or medications to reduce inflammation. Surgical intervention might be necessary for more severe cases involving septoplasty, turbinate reduction, or nasal valve reconstruction. The degree of the stenosis, the underlying reason, the patient's general health, and personal preferences all influence the treatment option. To choose the best course of therapy, it is crucial to speak with a healthcare expert.

2. How Can Nasal Valve Stenosis Be Diagnosed?

Diagnosing nasal valve stenosis involves a thorough evaluation by an ear, nose, and throat specialist. The process often begins with a comprehensive medical history and physical examination, focusing on nasal airflow and any associated symptoms. Additionally, diagnostic tests such as nasal endoscopy, rhinomanometry, or computed tomography (CT) scans may be conducted to assess the nasal passages and identify the extent and location of the stenosis. The combined information from these assessments helps formulate an accurate diagnosis and determine the appropriate course of treatment for the patient.

3. What Is the Primary Cause of Obstruction in the Nasal Valve?

The primary cause of obstruction in the nasal valve typically relates to structural abnormalities or changes in the nasal anatomy. These can include weakened or collapsed nasal cartilage, nasal septum deviations, or excessive tissue growth, often due to trauma, aging, or congenital factors. Additionally, chronic inflammation, allergic reactions, or nasal polyps can contribute to narrowing and obstruction of the nasal valve. Identifying the root cause is crucial for devising an effective treatment plan to alleviate the obstruction and improve nasal airflow.

4. What Leads to Nasal Vestibular Stenosis?

Nasal vestibular stenosis is often caused by various factors, primarily relating to the narrowing or constriction of the nasal vestibule—the area just inside the nostrils. Trauma or injury to the nasal region, previous surgeries, infections, or inflammatory conditions can lead to scarring and tissue contracture, resulting in decreased nasal airflow and stenosis. In some cases, congenital abnormalities or developmental issues may also contribute to this condition. Accurate diagnosis and understanding of the underlying causes are vital for developing an effective treatment approach to address nasal vestibular stenosis.

5. How Can Nasal Vestibular Stenosis Be Treated?

Addressing nasal vestibular stenosis typically involves a combination of non-surgical and surgical interventions. Non-surgical options may include nasal saline sprays, decongestants, or nasal dilator strips to improve airflow temporarily. However, surgical procedures like vestibuloplasty or grafting may be necessary for more severe cases to reconstruct and widen the narrowed nasal vestibule. The best course of action for improving breathing and overall nasal function will depend on the severity of the stenosis, its underlying etiology, and the patient's general health. To choose the best course of therapy, it is essential to consult with a medical expert.

6. How Long Does It Take to Recover from Nasal Valve Repair?

The length and complexity of the treatment determine how long the person needs to recuperate after having the nasal valve repaired. Generally, a full recovery can take several weeks to a few months. Initially, there may be swelling, bruising, and mild discomfort, which subsides gradually. Patients are advised to follow post-operative instructions, avoid strenuous activities, and attend follow-up appointments to monitor healing progress. Over time, individuals can expect improved breathing and reduced nasal obstruction as the nasal passages heal and adapt to the surgical changes.

7. What Should One Anticipate Post Nasal Valve Repair?

After nasal valve repair, individuals can anticipate a gradual improvement in nasal breathing and airflow. Initially, there might be some swelling, bruising, and mild discomfort, which should lessen in the weeks following the procedure. Patients are advised to diligently follow any prescribed post-operative care instructions, attend scheduled follow-up appointments, and communicate concerns to their healthcare provider. The post-repair period's overall objective is to guarantee effective healing and a good conclusion, which will eventually result in improved nasal function and a higher quality of life.

8. Is It Possible to Address Nasal Valve Collapse Without Surgery?

Nasal valve collapse may be addressed without surgery through non-invasive or minimally invasive techniques. These can include using nasal dilator strips or stents that help to keep the nasal passages open and improve airflow. Additionally, targeted exercises and breathing techniques, under a healthcare professional's or specialized therapist's guidance, can help strengthen the nasal muscles and provide some relief. However, the effectiveness of non-surgical approaches may vary based on the severity and cause of the nasal valve collapse. It is important to consult a healthcare provider to determine the most suitable approach for each case.

9. How Can Nasal Valve Stenosis Be Resolved?

Resolving nasal valve stenosis typically involves a comprehensive approach, often beginning with non-surgical interventions. These may include nasal saline sprays, decongestants, or nasal dilators to improve airflow. Surgical options like nasal valve reconstruction or septoplasty might be recommended in cases where conservative measures are insufficient. The selected course of action is to reduce blockage and improve nasal breathing, depending on the degree of stenosis, the underlying reasons, and the patient's general health.

10. What Is the Success Rate of Nasal Valve Surgery?

The likelihood of a successful nasal valve surgery varies depending on the particular technique, the patient's general health, and the kind and severity of the nasal valve problem. Generally, nasal valve surgery has a high success rate in improving nasal airflow and reducing symptoms of nasal obstruction. Success is often measured by enhanced breathing, reduced congestion, and improved quality of life for the individual. Consultation with an experienced healthcare professional will provide a clearer understanding of the expected outcomes and success rates based on the unique circumstances of each case.

11. What Are the Sensations Associated with Nasal Valve Collapse?

A nasal valve collapse can manifest as sensations of nasal congestion, difficulty breathing through the nose, or a feeling of nasal obstruction. Individuals might experience a sensation of nasal "pinching" or collapsing during inhalation, particularly when engaging in physical activities. Some may also perceive a sense of inadequate airflow or airflow resistance in the nasal passages. These sensations can vary in intensity based on the severity and extent of the nasal valve collapse, necessitating evaluation and appropriate management for improved nasal function and overall well-being.

12. Can a Nasal Valve Be Repaired?

Yes, a nasal valve can often be repaired through various surgical procedures to reconstruct and strengthen the weakened or collapsed nasal valve structure. The specific surgical approach depends on the severity and cause of the collapse, with options such as nasal valve reconstruction, cartilage grafting, or septoplasty. A skilled ENT surgeon will assess the individual's condition and recommend the most suitable surgical technique to restore nasal valve function, improve airflow, and alleviate symptoms associated with nasal valve collapse.

13. How Can the Nasal Valve Be Strengthened?

Strengthening the nasal valve involves a combination of non-surgical techniques and targeted exercises. Non-surgical options may include using external nasal dilator strips or stents that support the nasal passages, aiding in keeping them open. Additionally, nasal breathing exercises and certain facial muscle-strengthening exercises prescribed by a healthcare professional or a specialized therapist can help improve the nasal valve's strength and stability. These efforts aim to enhance nasal airflow and overall respiratory function by fortifying the nasal passages.

14. What Is the Typical Recovery Period for Nasal Valve Issues?

The recovery period for nasal valve issues can vary based on the specific treatment and extent. Non-surgical interventions may involve minimal to no recovery time, allowing individuals to resume normal activities immediately. However, surgical procedures for nasal valve repair may require a recovery period of several weeks to a few months. Individuals may experience swelling, bruising, mild discomfort, and restricted physical activities during this time. Following post-operative instructions, attending follow-up appointments, and allowing the nasal passages to heal for optimal recovery and improved nasal function is essential.

15. Can Nasal Valve Collapse Naturally Heal Without Intervention?

Nasal valve collapse may not typically heal on its own without intervention. The structural nature of the collapse often requires targeted treatment to address the underlying issues causing the collapse. Non-surgical approaches like using nasal dilator strips or stents may provide temporary relief by assisting in maintaining nasal passage openness. Still, for a more permanent solution, surgical interventions such as nasal valve reconstruction or grafting are often necessary. To choose the best course of action for a successful resolution, speaking with a healthcare expert is crucial.

Sources

Dr. Akshay. B. K.

Otolaryngology (E.N.T)

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