Advertisement

Nasal Valve Surgery

  • Mümtaz Taner Torun
  • İbrahim Çukurova
  • Andrey Lopatin
Chapter

Abstract

The portion of the nose lying most anteriorly offers the greatest resistance to the passage of air into the airways and is termed the “nasal valve area” (“NVA”). For the nose to function properly, this valve needs to maintain its patency. A slight change in function may lead to obstruction to the passage of air through the nose and subsequent breathing problems. The NVA comprises three distinct regions: the interior and exterior nasal valves (INV and ENV) and the intervalve area (IVA) lying in between. The most narrow portion of the anterior airway in the nose is formed by the INV. Its boundaries are defined by the head of the inferior turbinate (i.e., the anterior portion of the turbinate), the septum and the caudal part of the upper lateral cartilage. The ENV is found caudally with respect to the INV, being bound by the piriform aperture, the lower lateral cartilage and the adjoining entities and the caudal portion of the septum. The IVA defines a region between internal and external valve areas and found just to the lateral aspect of the lateral crura in the lower lateral cartilages, in other words, from a surface anatomy viewpoint, in the same location as the supra alar crease. That the lower lateral cartilages and points of attachment are highly significant in the correct functioning of the nasal valve should be apparent. In this chapter, we discuss nasal valve surgery.

Keywords

Nasal valve Interior nasal valve Exterior nasal valve Resistance Surgery 

References

  1. 1.
    Nigro CE, Nigro JF, Mion O, Mello JF. Nasal valve: anatomy and physiology. Braz J Otorhinolaryngol. 2009;75:305–10.CrossRefGoogle Scholar
  2. 2.
    Bruintjes TD, Olphen AF, Hillen B, Weijs WA. Electromyography of the human nasal muscles. Eur Arch Otorhinolaryngol. 1996;253:464–9.CrossRefGoogle Scholar
  3. 3.
    Mlynski G, Grutzenmacher S, Plontke S, Mlynski B, Lang C. Correlation of nasal morphology and respiratory function. Rhinology. 2001;39:197–201.PubMedGoogle Scholar
  4. 4.
    Kim DW, Rodriguez-Bruno K. Functional rhinoplasty. Facial Plast Surg Clin N Am. 2009;17:115–31.CrossRefGoogle Scholar
  5. 5.
    Most SP. Trends in functional rhinoplasty. Arch Facial Plast Surg. 2008;10:410–3.CrossRefGoogle Scholar
  6. 6.
    Deroee AF, Younes AA, Friedman O. External nasal valve collapse repair: the limited alar-facial stab approach. Laryngoscope. 2011;121:474–9.CrossRefGoogle Scholar
  7. 7.
    Sazgar AA, Woodard C, Most SP. Preservation of the nasal valve area with a lateral crural hinged flap: a cadaveric study. Aesthet Plast Surg. 2012;36(2):244–7.  https://doi.org/10.1007/s00266-011-9797-6. Epub 2011 Aug 19CrossRefGoogle Scholar
  8. 8.
    Kalan A, Kenyon GS, Seemungal TA. Treatment of external nasal valve (alar rim) collapse with an alar strut. J Laryngol Otol. 2001;115:788–91.CrossRefGoogle Scholar
  9. 9.
    Wexler DB, Davidson TM. The nasal valve: a review of the anatomy, imaging, and physiology. Am J Rhinol. 2004;18(3):143–50.CrossRefGoogle Scholar
  10. 10.
  11. 11.
    Vestibular stenosis nasal valve collapse. http://www.sinussurgeryprocedure.com/vestibular-stenosis-nasal-valve-collapse/. Accessed 14 Dec 2015.
  12. 12.
    Hinderer KH. Chap. 6: Physiology. In: Fundamentals of anatomy and surgery of the nose. Birmingham, AL: Aesculapius Publishing Co.; 1971. p. 26–7.Google Scholar
  13. 13.
    Lang J. Clinical anatomy of the nose, nasal cavity, and paranasal sinuses. New York: Thieme Medical Publishers; 1989. p. 6–55.Google Scholar
  14. 14.
    Bachmann W, Legler U. Studies on the structure and function of the anterior section of the nose by means of luminal impressions. Acta Otolaryngol. 1972;73:433–42.CrossRefGoogle Scholar
  15. 15.
    Cole P. The four components of the nasal valve. Am J Rhinol. 2003;17(2):107–10.CrossRefGoogle Scholar
  16. 16.
    Núñez-Fernández D. Internal valve stenosis rhinoplasty. In: Meyers AD, editor. Medscape. http://emedicine.medscape.com/article/877468-overview. Accessed 14 Dec 2015.
  17. 17.
    Roth J. Nasal valve collapse. http://drjasonroth.com.au/nasal-valve-collapse/. Accessed 14 Dec 2015.
  18. 18.
    Friedman O, Cook TA. Conchal cartilage butterfly graft in primary functional rhinoplasty. Laryngoscope. 2009;119(2):255–62.CrossRefGoogle Scholar
  19. 19.
    Sheen JH. Spreader graft: a method of reconstructing the roof of the middle nasal vault following rhinoplasty. Plast Reconstr Surg. 1984;73(2):230–9.CrossRefGoogle Scholar
  20. 20.
    Ozturan O, Miman MC, Kizilay A. Bending of the upper lateral cartilages for nasal valve collapse. Arch Facial Plast Surg. 2002;4(4):258–61.CrossRefGoogle Scholar
  21. 21.
    Lee DS, Glasgold AI. Correction of nasal valve stenosis with lateral suture suspension. Arch Facial Plast Surg. 2001;3(4):237–40.CrossRefGoogle Scholar
  22. 22.
    O’Halloran LR. The lateral crural J-flap repair of nasal valve collapse. Otolaryngol Head Neck Surg. 2003;128(5):640–9.CrossRefGoogle Scholar
  23. 23.
    Buyuklu F, Cakmak O, Hizal E, Donmez FY. Outfracture of the inferior turbinate: a computed tomography study. Plast Reconstr Surg. 2009;123:1704.CrossRefGoogle Scholar
  24. 24.
    Seren E. A new surgical method of dynamic nasal valve collapse. Arch Otolaryngol Head Neck Surg. 2009;135(10):1010–4.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Mümtaz Taner Torun
    • 1
  • İbrahim Çukurova
    • 2
  • Andrey Lopatin
    • 3
  1. 1.ENT Department, Bandırma State HospitalBandırmaTurkey
  2. 2.Department of OtorhinolaryngologyUniversity of Health Sciences, Tepecik Training and Research HospitalİzmirTurkey
  3. 3.Medical Department, Policlinic No. 1Business Administration of the President of Russian FederationMoscowRussia

Personalised recommendations