PIC

 

 

The forward part of the nose is a critical area where the narrowest portion of the nasal airway is located.  They act as natural flow limiters that allow air we breathe to interact with the tissues in our nose to become conditioned before it enters our lungs.  Excessive narrowing or collapse of this region can often result in very bothersome nasal congestion.  There are two nasal valve regions.  Internal and External. 

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External nasal valve

The external nasal valve is formed by the nasal floor, the nasal side wall tissues, piriform aperature, and by the middle of the nose in the front called the columella.

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Internal nasal valve

The internal nasal valve region is composed of the area between the septum, floor of the piriform aperature, front of the inferior turbinate and the posterior border of the upper lateral nasal cartilages. 

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Repair of these regions usually require placement of a cartilage graft to either widen the region (ex. spreader graft)or to add stability (ex. batten graft) so dynamic collapse of the nostril areas is minimized.  The cartilage is typically taken from the septum, sometimes ear cartilage or rib cartilage maybe needed if sufficient quality cartilage is not available from the septum. 

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Requisites

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Nasal valve surgery may be an option for you if your evaluation reveals a nasal valve problem.

Following requisites are important prior to undergoing the procedure.

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• You are in reasonably good health with no critical unstable medical condition.

• You have had an evaluation with a qualified surgeon to determine appropriateness of the procedure. 

• You have discussed the procedure with your surgeon and understand potential risks & benefits of the procedure.

• Be able to stop blood thinning medications prior to the procedure.

 

 

Risks of Nasal Valve Surgery

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Although every surgery and treatment has risks, good news is that the procedure can be very safely performed for most with exceedingly small risk of serious complications.  Risks include the following.

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• Bleeding and infection.  Universal risk with all surgeries.  Some blood tinged nasal drainage is typical during recovery.  Severe bleeding and infection are rare. 

• Pain.  Typically the pain is very mild and well controlled with ibuprofen with tylenol if needed.

• Change to appearance of the nose.  Mild broadening or fullness maybe noted. 

• Need for further treatment.  Remaining congestion due to allergies or other problems will need continued treatment.  Other unexpected outcome may require additional treatment. 

• General Anesthesia if applicable.  Although risk is not zero, modern anesthesia is overwhelmingly safe.  Nausea and other anesthesia related problems may occur and may need further treatment.

What to expect

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• Surgery is typically performed under general anesthesia in the operating room.

• Most patients are discharged home the same day to convalesce at home.

• Nasal appearance usually does not change much if at all.  There maybe mild broadening or fullness.

• Light physical activity (walking) is encouraged during the recovery period. 

• You should avoid blowing your nose, heavy lifting, strenuous activities, and contact sports.

• Keeping the head of the bed elevated during sleep can help manage secretions..

• You will be using nasal saline spray to keep the nostril area clear of mucus and debris. 

• Followup appointment will be 1 week after surgery.  Nasal splints if placed, will be removed at that visit.

• On call physician is available 24-7 for any post surgery emergencies.  On call MD can be contacted 24-7 by calling our office.