Management of inner nasal valve insufficiency.

OBJECTIVE: To determine the efficacy of the upper lateral caudal edge management in treating patients with inner nasal valve insufficiency and collapse.

DESIGN: This was a prospective study in a group of patients suffering from nasal obstruction owing to nasal valve insufficiency. Forty-three patients, who had undergone septoplasty and inferior turbinectomy, were included. All patients presented with nasal obstruction resulting in persistent functional problems. An anatomically narrow nasal valve, valve collapse, or both were found during the clinical examination.

SETTING: A tertiary referral centre.

METHODS: Revision was undertaken using a new technique to restore the nasal valve, based on upper lateral caudal edge management.

MAIN OUTCOME MEASURES: Improvement in nasal airway patency evidenced by patient questioning, by clinical inspection of the nose, and by rhinomanometric results.

RESULTS: None of the patients had major complications. In 28 (65.1%) patients, symmetrically improved nasal airway patency and elimination of the subjective sensation of inspiratory collapse was found. In 12 (27.9%) patients, a remarkable asymmetric improvement in nasal obstruction was evident. Two (4.6%) patients reported a moderate breathing improvement, and in only one (2.3%) patient, revision was needed. The mean follow-up time was 18 months.

CONCLUSIONS: Our proposed method is an effective therapeutic approach in the management of inner nasal valve insufficiency. It reconstitutes the normal tension of the inner nasal valve and reestablishes the stiffness and resistance of the lateral nasal wall. It can be performed under local anesthesia in cooperative patients, with minimal morbidity and a high rate of success.