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Nasal Valve Collapse
Nasal valve collapse (also known as nasal valve stenosis) is an anatomical abnormality involving the side walls the nose. When there is weakening and collapse of the nasal valves the side walls of the nose tend to cave in (collapse) when a deep breath is taken through the nose. Typically the reason for nasal valve collapse is that there is inadequate structural support (i.e. cartilage) in the side walls of the nose or that the cartilage is not shaped in the ideal way to keep the nasal passages open. Although nasal valve collapse is often seen together with a deviated septum, the septum may not need to be deviated for nasal valve collapse to be present. In revision rhinoplasty, nasal valve collapse is seen in situations where too much cartilage was removed at the time of the initial rhinoplasty.
In revision rhinoplasty, nasal valve collapse is seen in situations where too much cartilage was removed at the time of the initial rhinoplasty. Removal of too much cartilage weakens the side walls of the nose, causing them to collapse in under the weight of the skin. Noses with thick skin are more prone to nasal valve collapse since they need stronger cartilage support for their heavier skin. There are also a number of anatomical abnormalities of the nose cartilages that make the person at high risk for nasal valve collapse. The most common one is called cephalic malposition of the alar cartilages. In plain English this is a condition where the cartilages that are supposed to be supporting the side walls of the nose are not in the correct location and need to be surgically repositioned to provide support for the nasal valve.
Correction of nasal valve collapse (also called nasal valve repair or nasal valve reconstruction) is often performed at the same time as septoplasty. Repair of nasal valve collapse typically requires adding (grafting) pieces of cartilage to support areas of structural weakness and collapse in the side walls of the nose. The cartilage grafts usually come from the septum of the nose although they may also be taken from the rib or the ear. Like septoplasty, nasal valve repair is an outpatient procedure and is performed with IV sedation or general anesthesia. If necessary, nasal valve repair can be performed at the same time as rhinoplasty or revision rhinoplasty. The incisions are typically all internal and are closed with dissolving sutures and no packing is placed inside the nose.
For most individuals having nasal valve reconstruction 5-6 days is adequate recovery for returning to basic activities (work, school, driving, shopping). No packing is needed but nose blowing and exercise should be avoided for 1-2 weeks. The areas where cartilage has been added (grafted) to the nasal valve will feel somewhat stiff for months, especially if rib cartilage is used. This stiffness will gradually improve over time.