Nasal Valve Surgery

Abstract

Assessment of nasal valve obstruction is complex, as it is quite difficult to diagnose the exact anatomical site of the nasal obstruction. The nose being a “subjective” organ, making “objective” assessments is always difficult. There is so much inter-observer variability in the diagnosis between experienced surgeons, and hence different management plans have been put forward by experienced surgeons focusing on individual anatomical components inside the nose rather than on the traditional internal and external nasal valve regions (Facial Plast Surg 27:179–91, 2011; Laryngoscope 119:1281–90, 2009; JAMA Facial Plast Surg 20:111–5, 2018; Allergy Rhinol (Providence) 4:e66–8, 2013; J Otolaryngol Head Neck Surg 47:15, 2018). In the author’s experience, the current system of classifying the nasal valve complex into external and internal nasal valve areas, although anatomically proven, is not helpful clinically and certainly not helpful in standardising teaching and training. The author has been using another method of assessing nasal valve obstruction using a nasal wall sub-unit classification system (ENT Audiol News 21:111–3, 2012; ENT Audiol News 21:86–7, 2012), over the last 13 years. In the author’s practice, this method has been useful in diagnosing and managing patients with nasal valve obstruction.