Nasal valve collapse

Nasal valve collapse is a condition in which airflow through the nose is restricted because the nasal valves narrow or collapse. The internal valve, formed by the nasal septum, the lower edge of the upper lateral cartilage and the inferior turbinate, is the narrowest part of the nasal airway, while the external valve is formed by the columella, the medial footplate and the alar rim. Obstruction is classed as static, a structural narrowing often caused by a deviated septum or scarring from earlier surgery, or dynamic, when a weak external valve collapses under the pressure difference of breathing in. The lateral nasal wall tends to thin with age, and rhinoplasty, septoplasty and nasal trauma can predispose to the problem. Diagnosis is clinical, based on observing the nose at rest and on forced breathing in and on the modified Cottle maneuver, with nasal endoscopy used to look for contributing structures. Management ranges from over-the-counter internal and external nasal dilators to surgery, which many patients end up having because conservative measures often give too little relief.