Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-26T22:01:57.210Z Has data issue: false hasContentIssue false
  • English
  • Français

Management of the narrow nose

Published online by Cambridge University Press:  17 April 2009

H Wallace ,
S Sood  and
A Rafferty
H Wallace*
Affiliation:
Department of Otolaryngology, Bradford Royal Infirmary, UK
S Sood
Affiliation:
Department of Otolaryngology, Bradford Royal Infirmary, UK
A Rafferty
Affiliation:
Department of Otolaryngology, Bradford Royal Infirmary, UK
*
Address for correspondence: Miss H Wallace, 1 Chaly Fields, Boston Spa LS23 6BE, UK. E-mail: hcwallace@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Nasal obstruction is one of the most common complaints in the otolaryngology clinic. It can be a complex problem and may be multifactorial. Nasal valve dysfunction can be a cause of nasal obstruction, particularly in patients who have undergone previous reduction rhinoplasty. The exact site of the nasal valve is contentious and is frequently subdivided into the internal and external nasal valves. Accurate assessment is crucial for correct diagnosis and management planning. Various surgical and non-surgical techniques for addressing the problem of nasal valve collapse have been described in the literature. The choice of technique will depend on the causative pathology, availability of graft material, surgical experience and patient preference.

Keywords

Nasal ObstructionNasal CavityOtorhinolaryngologic Surgical Procedures
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 9 , September 2009 , pp. 945 - 951
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Wexler, DB, Davidson, TM. The nasal valve: a review of the anatomy, imaging and physiology. Am J Rhinol 2004;18:143–50CrossRefGoogle Scholar
2 Toriumi, DM, Josen, J, Weinberger, M, Tardy, ME. Use of alar batten grafts for correction of nasal valve collapse. Arch Otolaryngol Head Neck Surg 1997;123:802–8CrossRefGoogle ScholarPubMed
3 Bruintjes, TD, Van Olphen, SF, Hillen, B, Huizing, EH. A functional anatomical study of the relationship of the nasal cartilages and muscles to the nasal valve area. Laryngosocope 1998;108:1025–32CrossRefGoogle Scholar
4 Menger, DJ. Lateral crus pull-up. A method for collapse of the external valve. Arch Facial Plast Surg 2006;8:333–7CrossRefGoogle Scholar
5 Cole, P. The four components of the nasal valve. Am J Rhinol 2003;17:107–10CrossRefGoogle ScholarPubMed
6 Haight, JS, Cole, P. The site and function of the nasal valve. Laryngoscope 1983;93:49–55CrossRefGoogle ScholarPubMed
7 Kasperbauer, JL, Kern, EG. Nasal valve physiology: implications in nasal surgery. Otolaryngol Clin North Am 1987;20:699–719CrossRefGoogle ScholarPubMed
8 Schloser, RJ, Park, SS. Functional nasal surgery. Otolaryngol Clin North Am 1999;32:37–51CrossRefGoogle Scholar
9 Bridger, GP, Proctor, DF. Maximum nasal inspiratory flow and nasal resistance. Ann Otol 1970;79:481–8Google ScholarPubMed
10 Jones, AS, Wight, RG, Stevens, JC, Beckingham, E. The nasal valve: a physiological and clinical study. J Laryngol Otol 1988;102:1089–94CrossRefGoogle Scholar
11 Grymer, LF. Reduction rhinoplasty and nasal patency: change in the cross sectional area of the nose evaluated by acoustic rhinometry. Laryngoscope 1995;105:429–315CrossRefGoogle ScholarPubMed
12 Nolst Trenite, GJ. Nasal valve surgery: a modified Z-plasty. In: Nolst Trenite, GJ, ed. Rhinoplasty. A Practical Guide to Functional and Aesthetic Surgery of the Nose. The Hague: Kulger Publications, 1993;75–8Google Scholar
13 Millman, B. Alar batten grafting for management of the collapsed nasal valve. Laryngoscope 2002;112:574–9CrossRefGoogle ScholarPubMed
14 Erdem, T, Ozturan, O, Erdem, G, Akarcay, M, Cem Miman, M. Nasal pyriform aperture stenosis in adults. Am J Rhinol 2004;18:57–62CrossRefGoogle ScholarPubMed
15 O'Halloran, LR. The lateral crural J flap repair of nasal valve collapse. Otolaryngol Head Neck Surg 2003;128:640–9Google ScholarPubMed
16 Weiner, J, Abrahamson, M, Puy, R. Intranasal corticosteroids versus oral H1 receptor antagonists in allergic rhinitis: systematic review of randomised controlled trials. BMJ 1998;317:1624–9CrossRefGoogle ScholarPubMed
17 Roithmann, R, Chapnik, J, Zamel, N, Menna Barreto, S, Cole, P. Acoustic rhinometric assessment of the nasal valve. Am J Rhinol 1997;11:379–85CrossRefGoogle ScholarPubMed
18 Viaman, M, Shlamkovich, N, Eviatar, E, Segal, S. Treatment of nasal valve collapse with transcutaneous and intranasal electrical stimulation. Ear Nose Throat J 2004;83:757–62CrossRefGoogle Scholar
19 Sheen, JH. Spreader graft: a method of reconstructing the roof of the middle nasal vault following rhinoplasty. Plast Reconstr Surg 1984;73:230–9CrossRefGoogle Scholar
20 Khosh, M, Jen, A, Honrado, C, Pearlman, S. Nasal valve reconstruction. Arch Facial Plast Surg 2004;6:167–71CrossRefGoogle ScholarPubMed
21 Guyuron, B, Michelow, B, Englebardt, C. Upper lateral splay graft. Plast Reconstr Surg 1998;102:2169–77CrossRefGoogle ScholarPubMed
22 Gruber, RP, Park, E, Newman, J, Berkowitz, L, Oneal, R. The spreader flap in primary rhinoplasty. Plast Reconstr Surg 2007;119:1903–10CrossRefGoogle ScholarPubMed
23 Nyte, C. Spreader graft injection with calcium hydroxyapatite: a non surgical technique for internal nasal valve collapse. Laryngoscope 2006;116:1291–2CrossRefGoogle Scholar
24 Stucker, FJ, Hoasjoe, DK. Nasal reconstruction with conchal cartilage. Correcting valve and lateral nasal collapse. Arch Otolaryngol Head Neck Surg 1994;120:653–8CrossRefGoogle ScholarPubMed
25 Clark, J, Cook, T. The butterfly graft in functional secondary rhinoplasty Laryngoscope 2002;112:1917–25CrossRefGoogle ScholarPubMed
26 Ramakrisnan, JB, Danner, CJ, Yee, SW. The use of porous polyethylene implants to correct nasal valve collapse. Otolaryngol Head Neck Surg 2007;136:357–61CrossRefGoogle Scholar
27 Gurlek, A, Celik, M, Fariz, A, Ersoz-Ozturk, A, Eren, AT, Tenekeci, G. The use of high-density porous polyethylene as a custom-made nasal spreader graft. Aesth Plast Surg 2006;30:34–41CrossRefGoogle ScholarPubMed
28 Woodhead, CJ. Piriform aperture surgery for alar collapse. Clin Otolaryngol 1995;20:74–9CrossRefGoogle ScholarPubMed
29 Paniello, RC. Nasal valve suspension. An effective treatment for nasal valve collapse. Arch Otolaryngol Head Neck Surg 1996;122:1342–6CrossRefGoogle ScholarPubMed
30 Friedman, M, Ibrahim, H, Syed, Z. Nasal valve suspension: an improved, simplified technique for nasal valve collapse. Laryngoscope 2003;113:381–5CrossRefGoogle ScholarPubMed
31 Ozturan, O, Cem Miman, M, Kizilay, A. Bending of the upper lateral cartilages for nasal valve collapse. Arch Facial Plast Surg 2002;4:258–61CrossRefGoogle ScholarPubMed
32 Troell, RJ, Powell, NB, Riley, RW, Li, KK. Evaluation of a new procedure for nasal alar rim and valve collapse: nasal alar rim reconstruction. Otolaryngol Head Neck Surg 2000;122:204–11CrossRefGoogle ScholarPubMed
33 Gunter, JP, Friedman, RM. The lateral crural strut graft: technique and clinical applications in rhinoplasty. Plast Reconstr Surg 1997;99:943–52CrossRefGoogle ScholarPubMed
34 Kalan, A, Kenyon, G, Seemungal, T. Treatment of external nasal valve (alar rim) collapse with an alar strut. J Laryngol Otol 2001;115:788–91CrossRefGoogle ScholarPubMed