Draft:External nasal valve collapse
Submission declined on 26 April 2025 by Jlwoodwa (talk).
Where to get help
How to improve a draft
You can also browse Wikipedia:Featured articles and Wikipedia:Good articles to find examples of Wikipedia's best writing on topics similar to your proposed article. Improving your odds of a speedy review To improve your odds of a faster review, tag your draft with relevant WikiProject tags using the button below. This will let reviewers know a new draft has been submitted in their area of interest. For instance, if you wrote about a female astronomer, you would want to add the Biography, Astronomy, and Women scientists tags. Editor resources
|  |
| External nasal valve collapse | |
|---|---|
| Other names | External nasal valve insufficiency, lateral wall collapse |
| Specialty | Otolaryngology, Facial plastic and reconstructive surgery |
| Symptoms | Nasal obstruction, inspiratory collapse of nostrils, impaired breathing during exercise, snoring |
| Complications | Chronic mouth breathing, sleep disturbance, reduced quality of life, aesthetic deformity |
| Causes | Iatrogenic (e.g., post-rhinoplasty), trauma, congenital hypoplasia, age-related weakening |
| Risk factors | Previous nasal surgery, septal deviation, thin skin envelope, weak cartilage |
| Treatment | Structural grafts, nasal implants, revision rhinoplasty |
| Frequency | Common and underdiagnosed |
External nasal valve collapse is a structural disorder involving insufficient support of the lateral nasal wall, resulting in narrowing or collapse of the nasal airway during inspiration. This dysfunction affects the most anterior part of the nasal passage and is a frequently underdiagnosed contributor to chronic nasal obstruction.[1]
Anatomy
[edit]The external nasal valve includes the alar rim, lower lateral cartilage, nasal sill, and surrounding soft tissue. It is bordered medially by the columella and laterally by the lateral crus of the lower lateral cartilage. Unlike the internal nasal valve, which depends on fixed bony and cartilaginous angles, the external valve relies more heavily on the integrity of soft tissue and cartilage to maintain patency.[2]
Etiology
[edit]The condition may be congenital or acquired. Congenital hypoplasia of the lower lateral cartilage may predispose individuals to early collapse. Acquired causes include iatrogenic weakening following rhinoplasty, particularly over-resection of the lateral crus,[3][4] as well as blunt nasal trauma, age-related cartilage atrophy, and structural changes resulting from chronic inflammation or previous surgery involving the nasal ala.
Pathophysiology
[edit]Collapse occurs when the nasal sidewall lacks sufficient structural resistance to inspiratory negative pressure. In static collapse, obstruction is present at rest, while dynamic collapse is more prominent during deep inspiration. This condition is often seen in combination with other structural abnormalities such as internal nasal valve narrowing or septal deviation, which together exacerbate airflow limitation.[5]
Clinical presentation
[edit]Patients typically report persistent nasal blockage that does not improve with medical therapy. Other symptoms may include visible nostril collapse during inspiration, habitual mouth breathing, impaired sleep, decreased exercise tolerance, and reduced sense of smell.
Diagnosis
[edit]Diagnosis is primarily clinical, based on physical examination during normal and forced inspiration. The modified Cottle maneuver—lateral traction on the cheek that improves airflow—can support a diagnosis of valve dysfunction. Nasal endoscopy is used to evaluate internal anatomy, while acoustic rhinometry and rhinomanometry provide objective measures of nasal resistance. Computed tomography (CT) may be indicated in patients with prior surgery or complex anatomy.[6]
Management
[edit]Surgical intervention is the mainstay of treatment for symptomatic external valve collapse. Several techniques are used to restore lateral wall stability. Alar batten grafts placed along or above the lateral crus reinforce the sidewall and improve its resistance to collapse.[7] Lateral crural strut grafts are inserted beneath the lateral crus to reposition and stabilize weakened cartilage.[8] Alar rim grafts support the margin of the nostril and help maintain its shape and caliber.[9]
In some cases, suture-based suspension techniques are employed to provide temporary or adjunctive support to the lateral nasal wall.[10] Bioabsorbable implants made of polylactic acid may be inserted under local anesthesia and offer a minimally invasive option for selected patients.[11]
Revision rhinoplasty
[edit]When external valve collapse results from a prior rhinoplasty, revision surgery is often required. This may involve restoring cartilage support, correcting previous over-resection, and addressing aesthetic concerns. Outcomes are improved when functional restoration is integrated with aesthetic planning.[12][13][14]
Prognosis
[edit]Surgical treatment is generally associated with improved nasal breathing, better sleep quality, and enhanced quality of life. Long-term success depends on accurate diagnosis, appropriate graft placement, and adherence to surgical principles that preserve or restore nasal function.[15]
References
[edit]- ^ Ishii, LE (2014). "Evidence-based medicine: evaluation and treatment of nasal valve collapse". Otolaryngologic Clinics of North America. 47 (2): 235–244. doi:10.1016/j.otc.2013.12.006 (inactive 25 April 2025).
{{cite journal}}: CS1 maint: DOI inactive as of April 2025 (link) - ^ Patel, ZM (2019). "Nasal valve surgery: when, why, and how?". Laryngoscope Investigative Otolaryngology. 4 (2): 226–232. doi:10.1002/lio2.266. PMC 6580056. PMID 31236464.
- ^ André, RF (2004). "Nasal valve surgery: an overview of 123 consecutive cases". Facial Plastic Surgery. 20 (4): 215–223. doi:10.1055/s-2004-832243.
- ^ Constantian, MB (2004). "An 18-Year Experience in Revision Rhinoplasty: A Treatment-Oriented Classification System for Assessment and Management". Plastic and Reconstructive Surgery. 114 (5): 1225–1236. doi:10.1097/01.PRS.0000135219.11309.12 (inactive 25 April 2025).
{{cite journal}}: CS1 maint: DOI inactive as of April 2025 (link) - ^ Rhee, JS (2010). "Clinical Consensus Statement: Diagnosis and Management of Nasal Valve Collapse". Otolaryngology–Head and Neck Surgery. 143 (1): 48–59. doi:10.1016/j.otohns.2010.03.018. PMID 20620614.
- ^ Pellegrini, AR (2020). "Surgical treatment options in nasal valve collapse: a review of techniques and outcomes". Current Opinion in Otolaryngology & Head and Neck Surgery. 28 (1): 30–35. doi:10.1097/MOO.0000000000000597. PMID 31789927.
- ^ Toriumi, DM (1997). "Structural approach to primary rhinoplasty". Facial Plastic Surgery Clinics of North America. 5: 1–20.
- ^ Most, SP (2006). "Analysis of outcomes after functional rhinoplasty using spreader grafts". Archives of Facial Plastic Surgery. 8 (3): 202–207. doi:10.1001/archfaci.8.3.202.
- ^ Farrior, RT (2017). "Alar rim grafting in primary and revision rhinoplasty: analysis of aesthetic and functional outcomes". Facial Plastic Surgery Clinics of North America. 25 (2): 147–158. doi:10.1016/j.fsc.2016.12.002. PMID 28340647.
- ^ Clark, JM (2021). "Outcomes of lateral nasal wall suspension with sutures in nasal valve collapse". Facial Plastic Surgery. 37 (4): 439–445. doi:10.1055/s-0041-1730011 (inactive 25 April 2025).
{{cite journal}}: CS1 maint: DOI inactive as of April 2025 (link) - ^ Stolovitzky, P (2019). "Long-term outcomes after treatment of nasal valve collapse with a bioabsorbable implant". Facial Plastic Surgery. 35 (6): 599–605. doi:10.1055/s-0039-1694003.
- ^ "Rhinoplasty and Nasal Valve Collapse". NYC Face Doc. 17 October 2024. Retrieved April 21, 2025.
- ^ "Nasal Valve Collapse – Diagnosis and Treatment". NYC Face Doc. Retrieved April 21, 2025.
- ^ Pastorek, NJ (2013). "External valve collapse: Diagnosis and surgical management". Facial Plastic Surgery Clinics of North America. 21 (2): 227–236. doi:10.1016/j.fsc.2013.01.004 (inactive 25 April 2025).
{{cite journal}}: CS1 maint: DOI inactive as of April 2025 (link) - ^ Becker, DG (2011). "The fate of autologous cartilage grafts in nasal valve surgery". Facial Plastic Surgery. 27 (4): 273–280. doi:10.1055/s-0031-1293087.
- Promotional tone, editorializing and other words to watch
- Vague, generic, and speculative statements extrapolated from similar subjects
- Essay-like writing
- Hallucinations (plausible-sounding, but false information) and non-existent references
- Close paraphrasing
Please address these issues. The best way to do it is usually to read reliable sources and summarize them, instead of using a large language model. See our help page on large language models.