Obstruction of the nasal valve

1996 ◽  
Vol 110 (3) ◽  
pp. 221-224 ◽  
Author(s):  
Samy Elwany ◽  
Hossam Thabet
Keyword(s):  
Surgical Procedures ◽  
Lateral Cartilage ◽  
Nasal Resistance ◽  
Nasal Airflow ◽  
Nasal Patency ◽  
Nasal Valve ◽  
Nasal Surgery ◽  
History Of ◽  
Upper Lateral Cartilage ◽  
The Mean

AbstractObstruction of the nasal valve is an important cause of chronic nasal obstruction in adults. In a series of 500 patients, obstruction at the level of the nasal valve was diagnosed in 65 of them (13 per cent). The obstruction was unilateral in 57 patients (88 per cent). Forty-seven patients (72 per cent) had history of previous nasal surgery of accidental trauma. Causes of obstruction of the nasal valve included high septal deviations, a weak or deformed upper lateral cartilage, adhesions, and alar collapse. All patients underwent corrective nasal surgery and the surgical procedures were tailored according to the existing pathology. Post-operatively, the mean nasal patency score increased from 2.9 to 8.6, the mean nasal airflow increased from 579.5 to 727 cm/sec (at 150 Pa), and the mean nasal resistance decreased from 0.31 to 0.23 Pa/cm3sec-1.

History of Dorsum Conservative Techniques in Rhinoplasty: The Evolution of a Revived Technique

2021 ◽  
Author(s):  
Diego Arancibia Tagle ◽  
Jose Carlos Neves ◽  
Alwyn D'Souza
Keyword(s):  
Lateral Cartilage ◽  
Classic Problem ◽  
Alternative Option ◽  
History Of ◽  
Upper Lateral Cartilage ◽  
The Aesthetic

AbstractThe correction and management of the nasal hump has been a classic problem in rhinoplasty since the beginning of the aesthetic purpose of this surgery. For many years, the resective technique described by Joseph has been the battle horse to solve this problem but it has several drawbacks if not done properly. In the late 19th and early 20th centuries, a new dorsal conservative technique was born and for several years was an alternative option to treat the same problem without damaging the keystone area while preserving the dorsal connection between the upper lateral cartilage and the septum. The aim of this article is to review the history and evolution of this technique, which has been reborn after several years, and how it has evolved since then.

Airflow and the Nasal Cycle: Nasal Patency Fluctuations after Laryngectomy

1995 ◽  
Vol 9 (3) ◽  
pp. 175-178 ◽  
Author(s):  
Edward W. Fisher ◽  
Ming Liu ◽  
Valerie J. Lund
Keyword(s):  
Mean Amplitude ◽  
Afferent Input ◽  
Acoustic Rhinometry ◽  
Nasal Airflow ◽  
Nasal Patency ◽  
Cross Sectional ◽  
Exact Test ◽  
Nasal Cycle ◽  
Postoperative Time ◽  
The Mean

A periodic fluctuation in nasal patency or “nasal cycle” is observed in the majority of adults but has not hitherto been demonstrated in individuals after diversion of nasal airflow. Acoustic rhinometry, a highly sensitive technique which does not require airflow, provided the opportunity to evaluate this situation in patients who had undergone laryngectomy. We examined 21 postoperative individuals (mean postoperative time 4 years) and 14 control subjects matched for age (including 2 patients prelaryngectomy). Acoustic rhinometry was performed serially over 3–8 hours to determine minimum cross-sectional area and nasal cavity volume as indices of nasal patency. Fluctuations in nasal patency were observed in all laryngectomees and controls. These were classified as classical (reciprocal alternating), in concert (parallel) or irregular. The distribution of the control and laryngectomy subjects between the cycle categories was not statistically significant (Fisher's exact test: P > 0.05). The mean periodicity of the cycle was similar in the two groups (controls: 180 minutes, laryngectomees: 176 minutes), but the mean amplitude was significantly less in the laryngectomy group (68 versus 96 cm3; P < 0.07 Mann-Whitney U test). The nasal cycle can continue after cessation of airflow, but it is diminished in amplitude. Therefore, afferent input from nasal airflow receptors may continue to play a role in modulating the cycle's periodicity and amplitude, but are not responsible for generating the underlying cycle phenomenon.

scholarly journals Absorbable Implant to Treat Nasal Valve Collapse

2017 ◽  
Vol 33 (02) ◽  
pp. 233-240 ◽  
Author(s):  
Marion Nicoló ◽  
Klaus Stelter ◽  
Haneen Sadick ◽  
Murat Bas ◽  
Alexander Berghaus
Keyword(s):  
Lateral Cartilage ◽  
Nasal Valve ◽  
Cosmetic Appearance ◽  
Acid Copolymer ◽  
Symptom Evaluation ◽  
Absorbable Implant ◽  
The Mean ◽  
Nasal Valve Collapse ◽  
Operating Suite

Objective To evaluate the safety and effectiveness of an absorbable implant for lateral cartilage support in subjects with nasal valve collapse (NVC) with 12 months follow-up. Methods Thirty subjects with Nasal Obstruction Symptom Evaluation (NOSE) score ≥ 55 and isolated NVC were treated; 14 cases were performed in an operating suite under general anesthesia and 16 cases were performed in a clinic-based setting under local anesthesia. The implant, a polylactic acid copolymer, was placed with a delivery tool within the nasal wall to provide lateral cartilage support. Subjects were followed up through 12 months postprocedure. Results Fifty-six implants were placed in 30 subjects. The mean preoperative NOSE score was 76.7 ± 14.8, with a range of 55 to 100. At 12 months, the mean score was 35.2 ± 29.2, reflecting an average within-patient reduction of –40.9 ± 31.2 points. The majority (76%) of the subjects were responders defined as having at least one NOSE class improvement or a NOSE score reduction of at least 20%. There were no adverse changes in cosmetic appearance at 12 months postprocedure. Three implants in three subjects required retrieval within 30 days postprocedure and resulted in no clinical sequelae. Conclusion This study demonstrates safety and effectiveness of an absorbable implant for lateral cartilage support in subjects with NVC at 12 months postprocedure.

Exercise and nasal patency

1983 ◽  
Vol 55 (3) ◽  
pp. 860-865 ◽  
Author(s):  
R. D. Forsyth ◽  
P. Cole ◽  
R. J. Shephard
Keyword(s):  
Short Duration ◽  
Healthy Subjects ◽  
Time Course ◽  
Nasal Resistance ◽  
Exercise Recovery ◽  
Nasal Airflow ◽  
Nasal Patency ◽  
Progressive Decrease ◽  
Sudden Decrease

Nasal airflow resistances were studied in 20 healthy subjects at rest, with exercise, and during recovery from exercise. Resistances were first measured under resting conditions. As a basis for comparison 0.1% xylometazoline was applied by insufflation; it reduced nasal resistance by an average of 49%. On a subsequent occasion, the degree and time course of changes in resistance were measured 1) during 5-min exercise bouts at rest 25, 50, and 75% of predicted maximum O2 intake (VO2max), 2) during 5-, 10-, and 15-min exercise bouts at 50% of VO2max, and 3) during recovery from exercise. Resistance decreased with intensity but not duration of exercise; an initial sudden decrease was followed by a more gradual but progressive decrease, which continued for several minutes following vigorous short duration exercise. Thus following 5 min of effort at 75% of VO2max, resistance reached a nadir (46% fall) 5 min after cessation of exercise. Recovery of preexercise values required 5 min after 5 min of exercise at 25% of VO2max and 10 min after 5 min of exercise at 50% of VO2max. Some decrease persisted 15 min after 5 min of exercise at 75% of VO2max.

Endonasal Triangular Technique for nasal valve rhinoplasty: a ten year review

2018 ◽  
Vol 72 (5) ◽  
pp. 45-50
Author(s):  
Ngalufua'atonga Havea ◽  
Cheryl Tang ◽  
Jason Rockey ◽  
Angelica Lynch
Keyword(s):  
Nasal Obstruction ◽  
Revision Surgery ◽  
Lateral Cartilage ◽  
Endonasal Approach ◽  
Nasal Valve ◽  
Upper Lateral Cartilage ◽  
Main Regulator ◽  
Regional Hospitals ◽  
Subjective Reports

Introduction: The nasal valve is the main regulator of airflow in the nose. Consequently, the collapse of the nasal valve has a significant impact on nasal obstruction and hence quality-of-life of patients. Several nasal valve rhinoplasty techniques are being used, from cartilage grafts to endonasal resection of the upper lateral cartilage. We describe a new endonasal approach to nasal valve rhinoplasty, the Triangular Technique, and assess its efficacy and complication rate over ten years. Materials and Methods: A retrospective study of patients who underwent nasal valve rhinoplasty at three regional hospitals from Jan 2004 to May 2014 was conducted. Subjective reports were used to assess the improvement of nasal obstruction. 24 patients were included. Results: 3 months postoperatively, 19 patients reported improvement in nasal obstruction. 4 patients required revision surgery. 2 of these 4 patients had substantial symptom resolution post revision surgery. 10 patients were followed up for more than 5 years (range: 5.8 to 10.3 years), 9 of who reported continued satisfaction and none or minimal nasal obstruction after nasal valve rhinoplasty compared to before surgery. There were no reported complications. Discussion: The Triangular Technique is a straightforward endonasal technique to address collapsed nasal valves with minimal associated co-morbidities.

scholarly journals The complexities of nasal airflow: theory and practice

2019 ◽  
Vol 127 (5) ◽  
pp. 1215-1223 ◽  
Author(s):  
Graham O’Neill ◽  
Neil Samuel Tolley
Keyword(s):  
Theory And Practice ◽  
Poor Correlation ◽  
Airflow Rate ◽  
Nasal Resistance ◽  
Flow Limitation ◽  
Nasal Airflow ◽  
Nasal Valve ◽  
Cross Sectional ◽  
Pressure Flow ◽  
Valve Area

The objective of this study was to investigate the effects of nasal valve area, valve stiffness, and turbinate region cross-sectional area on airflow rate, nasal resistance, flow limitation, and inspiratory “hysteresis” by the use of a mathematical model of nasal airflow. The model of O’Neill and Tolley ( Clin Otolaryngol Allied Sci 13: 273–277, 1988) describing the effects of valve area and stiffness on the nasal pressure-flow relationship was improved by the incorporation of additional terms involving 1) airflow through the turbinate region, 2) the dependence of the flow coefficients for the valve and turbinate region on the Reynolds number, and 3) effects of unsteady flow. The model was found to provide a good fit for normal values for nasal resistance and for pressure-flow curves reported in the literature for both congested and decongested states. Also, by showing the relative contribution of the nasal valve and turbinate region to nasal resistance, the model sheds light in explaining the generally poor correlation between nasal resistance measurements and the results from acoustic rhinometry. Furthermore, by proposing different flow conditions for the acceleration and deceleration phases of inspiration, the model produces an inspiratory loop (commonly referred to as hysteresis) consistent with those reported in the literature. With simulation of nasal flaring, the magnitude of the loop, the nasal resistance, and flow limitation all show change similar to that observed in the experimental results. NEW & NOTEWORTHY The present model provides considerable insight into some difficult conundrums in both clinical and technical aspects of nasal airflow. Also, the description of nasal airflow mechanics based on the Hagen–Poiseuille equation and Reynolds laminar-turbulent transition in long straight tubes, which has figured prominently in medical textbooks and journal articles for many years, is shown to be seriously in error at a fundamental level.

The Four Components of the Nasal Valve

2003 ◽  
Vol 17 (2) ◽  
pp. 107-110 ◽  
Author(s):  
Philip Cole
Keyword(s):  
Cross Sectional Area ◽  
The Body ◽  
Isometric Contractions ◽  
Lateral Cartilage ◽  
Sectional Area ◽  
Nasal Valve ◽  
Cross Sectional ◽  
Airflow Resistance ◽  
Orifice Flow ◽  
Upper Lateral Cartilage

The nasal valve consists of four distinct airflow-resistive components. (i) The vestibule terminates in an airflow-resistive aperture between the septum and the caudal end of the upper lateral cartilage. Its cross-sectional area is stabilized by the cartilaginous structures and by inspiratory isometric contractions of alar dilator muscles. Its walls are devoid of erectile tissues that might otherwise affect its cross-sectional area and airflow resistance. By contrast, (ii) the bony entrance to the cavum is occupied by erectile tissues of both (iii) lateral (turbinate) and (iv) septal nasal walls that modulate the cross-sectional area of the airway and airflow resistance. The body of the cavum offers little resistance to airflow. Valve constrictions induce “orifice flow” of inspiratory air as it enters the body of the cavum, disrupting laminar characteristics and thereby enhancing exchanges with the nasal mucosa of heat, water, and contaminants. Acoustic rhinometric and rhinomanometric measurements show the sites, dimensions, and resistances of the valve constrictions and indicate that it is seldom necessary to extend septal and/or turbinate surgery far beyond the piriform aperture in the treatment of nasal obstruction.

Nasal airflow: resistance and sensation

1989 ◽  
Vol 103 (10) ◽  
pp. 909-911 ◽  
Author(s):  
A. S. Jones ◽  
D. J. Willatt ◽  
L. M. Durham
Keyword(s):  
Objective Measure ◽  
Nasal Resistance ◽  
Nasal Airflow ◽  
Nasal Patency ◽  
Airflow Resistance ◽  
Large Numbers ◽  
Two Parameters

AbstractFor many years nasal resistance to airflow measured by rhinomanometry has been regarded as the objective measure of nasal patency. However, recently it has become apparent that this may not be the case.The present study was designed to affirm or refute this view by using large numbers of subjects and observations.Five hundred estimations of (objective) nasal resistance to airflow and (subjective) nasal sensation of airflow where carried out.No correlation could be demonstrated between these two parameters.It is concluded nasal resistance to airflow and nasal sensation of airflow are two separate modalities which are not directly related. The possible reasons for this finding are discussed with reference to previous work on nasal sensation.

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