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An Effective Treatment for Nasal Valve Collapse

Randal C. Paniello, MD

Arch Otolaryngol Head Neck Surg. 1996;122(12):1342-1346.

Abstract
Objective
To evaluate a new operative technique for treating nasal valve collapse for safety and effectiveness.

Design
A nonrandomized pilot study of patients with complaints of nasal airway obstruction, a positive Cottle maneuver, and clinical findings of nasal valve collapse. Follow-up ranged from 1 to 20 months.

Setting
Academic medical center, including a Veterans Affairs hospital.

Patients
Twelve men aged 38 to 73 years (mean age, 59.3 years).

Main Outcome Measures
Subjective self-assessment scores for nasal airflow were collected on a 10-point scale. Anterior rhinomanometry, acoustic rhinometry, and photographic analysis provided objective data.

Intervention
The procedure involves accessing the orbital rim by a transconjunctival incision, then passing sutures from the nose to this incision where they may be affixed to the orbital rim. The collapsing tissue of the nasal valve is thus supported and collapse is prevented.

Results
All patients reported immediate subjective improvement in their symptoms of nasal obstruction; this was reflected in their self-assessment scores. The rhinomanometry showed reduced nasal resistance in 10 (83%) of 12 patients. The acoustic rhinometry showed an increase in minimum cross-sectional area in 2 (33%) of 6 patients, with the others remaining stable. The photographic analysis revealed mild widening of the midthird of the nose in 6 of 12 patients, although this was not of concern to the patients. There were no major complications.

Conclusion
Nasal valve suspension is a safe and effective procedure for treatment of nasal valve collapse.

Arch Otolaryngol Head Neck Surg. 1996;122:1342-1346

Author Affiliations
From the Department of Otolaryngology—Head and Neck Surgery, Washington University School of Medicine, and the Veterans Affairs Medical Center, St Louis, Mo.

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