Treatment of Nasal Valve Collapse

Obstruction at the level of the nasal valve is a common and long-recognized cause of nasal blockage. The nasal septum and lower lateral cartilages meet to form an angle in the front of the nostril.  This angle can be too narrow to allow effective breathing, or commonly the lateral cartilages and lateral nostril tissues may collapse inward when breathing to cause a severe obstruction.

It is estimated that about 60% of nasal obstruction is limited by the lateral nasal wall and internal valve in some way.  Despite this only about 5% of nasal breathing surgeries are intended to address this area.  Surgically treating this nasal valve obstruction has proven to be difficult over the years, either resulting in unfavorable cosmetic results (thickening of the nostrils) or resulting in persistent airway blockage.

We use traditional techniques of cartilage grafting to insert “spreaders” to assist in widening this valve angle, as well as surgical techniques to stiffen the nasal sidewall and prevent this collapse when breathing.  Usually these surgeries are done to augment the effects of septoplasty and turbinate reduction (or done commonly after a prior surgery failed to resolve the breathing problem).

The last two to three years have brought some advances in treating this area that promise less discomfort and less risk of cosmetically “over-widening” the nose.  The Spirox Latera received FDA clearance about two years ago and has been used in thousands of patients to stiffen the sidewalls of the nose.  This is an implant that is positioned beneath the nostril skin that helps to prevent this nasal collapse.  This procedure is most commonly done in combination with other nasal surgical procedures to help widen the nasal passages and improve nasal breathing.  And there is practically no widening or thickening of the nostrils (a major downside to the other aggressive surgeries aimed at correcting nostril collapse in this area).

A new contouring procedure is recently being done that uses controlled electrical energy and heat to mold the nostril cartilages.  This allows reshaping of the narrowest portion of the nasal valve with a 10 minute office procedure under local anesthesia.  This demonstrates noticeable results beginning the moment the procedure is done.  Unfortunately this procedure is not covered by private insurance (or medicare) but usually winds up costing less that out of pocket expenses for nasal surgery anyway.  This procedure is called the Aerin Vivaer Nasal Airway Re modelling Procedure (maybe we should find a catchier name?!).  Dr. Rogers was the first in ITP Atlanta to perform the procedure.

We offer full surgical treatments, lateral wall reinforcement procedures as well as the Vivaer contouring procedure.  An office evaluation is needed to make a determination which kind of procedure is best for you.