Cause Of Nasal Airway Obstruction Research Articles

Outcomes 12 Months After Temperature-Controlled Radiofrequency Device Treatment of the Nasal Valve for Patients With Nasal Airway Obstruction

Nasal valve collapse is a primary cause of nasal airway obstruction (NAO). Patients with NAO and nasal valve collapse experience a variety of symptoms that lower their quality of life, such as nasal congestion, headache, sleep disturbance, daytime sleepiness, and snoring. To determine if active treatment of the nasal valve with a temperature-controlled radiofrequency (TCRF) device, previously demonstrated superior to a sham procedure at 3 months, was safe and associated with sustained improvements in symptoms of NAO through 12 months. In a prospective, multicenter, single-blinded, randomized clinical trial, patients in 16 centers in the US with index procedures between August and December 2020 were assigned to TCRF device treatment of the nasal valve or a sham control procedure (no RF energy). Patients had a baseline Nasal Obstruction Symptom Evaluation (NOSE) Scale score of 55 or greater with nasal valve collapse as the primary or substantial contributor to NAO. After primary end point evaluation at 3 months, eligible patients in the sham control arm crossed over to active treatment. Data analysis was performed between April and May 2022. Patients were treated bilaterally with the TCRF device at 4 or fewer nonoverlapping areas on the nasal mucosa at the junction of the upper and lower lateral cartilage on the lateral nasal wall. The primary end point measure was responder rate, defined as 20% or greater reduction in NOSE Scale score or 1 or greater reduction in NOSE Scale clinical severity category. A total of 108 patients received active treatment (77 as index active treatment, 31 after crossover). The mean (SD) age of patients was 48.5 (12.3) years; 66 (61.1%) were women. The combined group of patients receiving active treatment had a mean baseline NOSE Scale score of 76.3 (95% CI, 73.6-79.1). At 12 months (n = 88), the responder rate was 89.8% (95% CI, 81.7%-94.5%). The NOSE Scale score improved from baseline (mean change, -44.9 [95% CI, -52.1 to -37.7]). No device/procedure-related serious adverse events were reported. In this follow-up of a cohort from a randomized clinical trial, the minimally invasive TCRF device, previously demonstrated to be superior to a sham procedure, was safe and associated with improvement in symptoms of NAO through 12 months postprocedure. ClinicalTrials.gov Identifier: NCT04549545.

Benefits of Turbinectomy vs Turbinoplasty – A Prospective Study

Introduction Inferior turbinate hypertrophy (ITH) is one of the major causes of nasal airway obstruction. Nasal obstruction due to inferior turbinate hypertrophy is noted in around 20% of the population. Surgical reduction of the hypertrophied inferior turbinate is required when medical treatment fails. This study aimed to compare the Nasal obstruction symptom evaluation (NOSE) scores and complications of inferior turbinate reduction by turbinectomy and turbinoplasty. Materials and Methods In this prospective observational randomized controlled study, 30 patients underwent turbinectomy and 30 underwent turbinoplasty. Pre and postoperative NOSE scores and incidence of postoperative bleeding and crusting were compared at first week and six months. Results The mean preoperative NOSE score of turbinectomy group was 75.83 and that of turbinoplasty group was 76.83. Both the groups showed statistically significant improvement (p< 0.05) in NOSE score post-operatively. Functional outcome is achieved with turbinoplasty by sparing the nasal mucosa and submucosa along with retention of function bearing structures (inferior turbinate). Though not statistically significant, the incidence of post-operative bleeding and crusting were lower after turbinoplasty, in comparison to turbinectomy. Conclusion Inferior turbinoplasty provides excellent outcome in a wide variety of patients with minimal morbidity. Turbinoplasty is associated with lesser mucosal injury, post-operative bleeding and crusting, and excellent outcome in terms of symptomatic relief and functionality. Hence, we recommend that it can be done for the treatment of ITH.

Congenital nasal pyriform aperture stenosis with holoprosencephaly and Dandy–Walker malformation

Congenital nasal pyriform aperture stenosis (CNPAS) is a recognized but rare and unusual cause of nasal airway obstruction in neonates. We describe an infant who has CNPAS with megaincisor, holoprosencephaly, agenesis of the corpus callosum with Dandy–Walker malformation, and central diabetes insipidus to highlight the importance of recognizing the variable abnormalities associated with this condition.

Inferior turbinectomy - outcome of various surgical modalities: a prospective study

<p class="abstract"><strong>Background:</strong> Inferior turbinate hypertrophy is one of the major causes of nasal airway obstruction. Medical treatment often produces insufficient improvement. In these circumstances, surgical reduction of inferior turbinate can be proposed. Many different techniques are currently available. The aim of our study is to prospectively evaluate the effectiveness of three techniques i.e., electrocautery, cryotherapy and radio frequency by comparing the response of patients to these surgical modalities of turbinate reduction.</p><p class="abstract"><strong>Methods:</strong> A total of 90 patients presenting with nasal obstruction with or without allergic symptoms, fulfilling the inclusion and exclusion criteria, attending ENT OPD are included in the study. A prospective study was conducted on three groups of thirty patients with symptoms and signs of nasal obstruction associated with inferior turbinate hypertrophy of more than 3 months duration. Then the percentage of subjective improvement in nasal airway is used to assess treatment outcomes 1 week, 1, 3, 6, 9 and 12 months after surgery. </p><p class="abstract"><strong>Results:</strong> At the end of 12 months, 56.6% of patients treated with electrocautery and 56.6% of patients treated with cryotherapy showed 75% improvement in nasal obstruction whereas 59.99% of patients treated with radio frequency showed 100% improvement. No statistical difference in the amount of improvement in nasal obstruction was noted between the three treatment groups at the end of 12 months because of relatively small sample size.</p><strong>Conclusions:</strong> On this basis it is evident that clinically radio frequency showed better subjective improvement in nasal obstruction when compared to cryotherapy and electrocautery.

Mechanical Nasal Dilators to Treat Nasal Valve Compromise

Nasal airway obstruction is a common clinical problem in the general adult population. Common structural causes of nasal obstruction include septal deviation, turbinate hypertrophy, nasal polyposis, and adenoid hypertrophy. However, another important and often overlooked etiology is nasal valve compromise.1 Nasal valve compromise is a distinct and primary cause of nasal airway obstruction and can occur in isolation or in combination with other anatomic or inflammatory causes of nasal obstruction.2 The nasal valve is the region of the nasal cavity with the greatest resistance to airflow. The nasal septum and inferior turbinate are rigid structures within the nose. The dynamic lateral nasal wall can have a significant effect on the nasal valve region and overall nasal airflow. Patients with nasal valve compromise may have a weakened lateral nasal wall, which contributes to the dynamic or static area of airflow restriction within the nose.

Congenital Nasal Pyriform Aperture Stenosis as a Rare Manifestation of Trisome 8 Mosaicsm: A Case Report

Congenital Nasal Pyriform Aperture Stenosis (CNPAS) is an extremely rare cause of nasal airway obstruction. Clinically, it mimics choanal atresia in neonate. It needs to be differentiated because management differs from each. Pyriform aperture is located at the most anterior part of the nose and is always the narrowest region of the nasal cavity. Therefore, nasal obstruction can easily occur if there is slight decrease in its cross sectional area. CNPAS rarely presents alone. Usually, it arises together with a midline developmental defect such as holoprosencephaly or pituitary defect. We present the first ever reported case of CNPAS, in association with Trisomy 8 Mosaicsm (T8M).

Posterior Septal Widening as a Cause of Nasal Airway Obstruction

Nasal airway obstruction, a well-known cause of patient discomfort, is one of the most common presenting complaints to the otolaryngologist. The different causes of nasal airway obstruction are very wide-ranging, spanning from congenital life threatening causes to acquired benign causes. Herein, we present a case of nasal obstruction caused by widening of the posterior septum. A 52-year-old gentleman presented to the rhinology clinic with complaint of chronic nasal congestion for 4 years. Trials of topical steroid sprays and nasal saline rinses had been unsuccessful in symptoma- tic resolution. On anterior rhinoscopy, the septum was noted to be straight anteriorly, but appeared to be deviated bilaterally, flaring into the nasopharynx and obstructing the airway. A CT scan was performed, which showed soft tissue enlargement on the posterior aspect of the septum. The patient was subsequently taken to the operating room for a posterior septectomy and inferior turbinectomy. He reported alleviation of symptoms postoperatively. It is important for the otolaryngologist to be aware of the myriad of causes of nasal airway obstruction. An accurate history and physical examination including anterior and posterior rhinoscopy is important in the diagnosis of nasal airway obstruction. More importantly, the physician should be aware of the possibility of a widened posterior septum as a cause of nasal airway obstruction.

Using the maxillary-nasal angle to evaluate congenital nasal pyriform aperture stenosis.

Congenital nasal pyriform aperture stenosis (CNPAS) is a rare cause of nasal airway obstruction in newborns. The decision to operate is made clinically. Although pyriform aperture width is used for diagnosing CNPAS, it does not fully characterize stenosis of the nasal cavity. To determine the utility of additional metrics for evaluating CNPAS. The medical records of 13 patients with CNPAS treated from 2007 through 2012 at a single tertiary pediatric facility were retrospectively examined. Data on patient demographic characteristics, known genetic abnormalities, and hospital courses were extracted. Computed tomographic images were evaluated for pyriform aperture width; maxillary-nasal angle (MNA), defined as the angle between the anterior maxilla and anterior-posterior nasal axis; and choanal width. Medical management and surgical management. Pyriform aperture width, MNA, and choanal width. Six of 13 patients underwent medical management, and 7 patients underwent surgical treatment. For patients who were managed medically as compared with those managed surgically, the evaluation revealed a larger pyriform aperture width (median [interquartile range {IQR}], 5.6 [5.4-6.1] vs 4.6 [4.5-4.7] mm; P = .03) and MNA (median [IQR], 70° [63°-73°] vs 59° [59°-64°]; P = .048) but no significant difference in choanal width (median [IQR], 11.0 [9.6-12.2] vs 11.9 [10.3-11.9] mm; P = .76). The MNA, when used in conjunction with pyriform aperture width, provides additional pertinent information to supplement clinical decision making in the evaluation of patients with CNPAS. These measurements may be helpful in identifying patients who should undergo surgical intervention, although additional studies would be required to allow predictive use of the MNA.

Comparative study of response through reduction in the size of hypertrophied inferior turbinate causing nasal obstruction by different surgical modalities: a prospective study.

Inferior turbinate hypertrophy is one of the major causes of nasal airway obstruction. Medical treatment often produces insufficient improvement. In these cases, surgical reduction of inferior turbinate can be proposed. Many different techniques are currently available. The aim of our study is to prospectively evaluate the effectiveness of three techniques i.e., electrocautery, cryotherapy and radiofrequency by comparing the response of patients to these three surgical modalities of turbinate reduction. A total of 90 patients presenting with nasal obstruction with or without allergic symptoms, fulfilling the inclusion and exclusion criteria, attending ENT OPD are included in the study. A prospective study was conducted on three groups of thirty patients with symptoms and signs of nasal obstruction associated with inferior turbinate hypertrophy of more than 3months duration. Then the percentage of subjective improvement in nasal airway is used to assess treatment outcomes 1week, 1, 3, 6, 9 and 12months after surgery. At the end of 12months, 56.6% of patients treated with electrocautery and 56.6% of patients treated with cryotherapy showed 75% improvement in nasal obstruction whereas 59.99% of patients treated with radiofrequency showed 100% improvement. No statistical difference in the amount of improvement in nasal obstruction was noted between the three treatment groups at the end of 12months because of relatively small sample size. But clinically radiofrequency showed better subjective improvement in nasal obstruction when compared to cryotherapy and electrocautery.

Comparison of submucosal resection and radiofrequency turbinate volume reduction for inferior turbinate hypertrophy: evaluation by magnetic resonance imaging.

Inferior turbinate hypertrophy is a frequent cause of nasal airway obstruction and drastically impairs patients' quality of life. Surgical reduction of the inferior turbinates can be used for patients who did not respond to medical therapy. A number of studies have been performed to identify the most effective technique. The aim of this study was to compare the effectiveness of submucosal resection (SMR) and radiofrequency turbinate volume reduction (RFTVR) in patients with inferior turbinate hypertrophy. A prospective, randomized case-control study was conducted. Sixty patients with inferior turbinate hypertrophy refractory to medical therapy were prospectively and randomly assigned to two groups: SMR and RFTVR. A visual analog scale (VAS) and the nasal inspiratory peak flow (NPIF) were analyzed pre- and postoperatively at the first week and second month. Magnetic resonance imaging was performed pre- and postoperatively at the second month. The surgical outcomes were compared statistically using subjective and objective measures. Significant turbinate volume reduction was achieved in both the SMR and RFTVR groups. However, turbinate volume reduction was significantly greater in the SMR than in the RFTVR group at the second month postoperatively. NIPF and VAS scores were improved after both procedures at the second month postoperatively. Beside this, surgical outcomes were significantly better after SMR in terms of NIPF and VAS scores. In this study, we demonstrated that both SMR and RFTVR are effective for inferior turbinate hypertrophy. Turbinate volume reduction, improvement of subjective nasal obstruction symptoms, and NIPF after SMR were significantly superior to those after RFTVR.

Septoturbinotomy

The inferior turbinates are a principal cause of nasal airway obstruction. To some extent, the bony septum (the perpendicular plate of the ethmoid) also, on occasion, contributes to that airflow obstruction. There are many excellent methods to resect or ablate the turbinates, including submucous resection and cauterization. However, some have been associated with bleeding, crusting, and the development of synechiae. In this Featured Operative Technique article, we propose 2 mechanical means to expand the nasal vault: (1) the insertion of a large and long speculum that outfractures the turbinates and also centralizes the bony septum when the handles are compressed and (2) the insertion of a large clamp, which is expanded (in reverse "nutcracker" fashion) to achieve a similar result. Mechanical dilation (expansion) of the nasal vault with the speculum or large clamp substantially improves vault diameter such that further work on the turbinates in the form of turbinectomy is seldom necessary. The nasal vault is not necessarily expanded to the maximal diameter that could be achieved with resection procedures but need not be to achieve satisfactory air flow. Septoturbinotomy is a quick and simple way to deal with inferior turbinate hypertrophy. It is a minimally invasive procedure that improves the airway in virtually all cases, such that turbinectomy is seldom employed. It can be used prophylactically on all rhinoplasty cases requiring lateral osteotomy, which potentially shrinks the nasal vault slightly.

Long-Term Efficacy of Radiofrequency Treatment of Turbinate Hypertrophy: A Patient Based Point of View

Nasal turbinate hypertrophy is a major cause of nasal airway obstruction that affects up to 20% of the European general population. This study aims to determine the efficacy of radiofrequency treatment as perceived by patients during a 2-years period. From 2007 to 2009, an observational study was conducted on 36 patients who consecutively underwent temperature-controlled radiofrequency tissue volume reduction. A questionnaire was administered to each patient in order to collect demographic data, lifestyle habits, health status and visual analogue scale (VAS) score of perceived symptoms. Mean VAS scores of nasal obstruction, headache, rhinorrhoea and anosmia after treatment were significantly lower than that at baseline. Urban residence and allergic rhinitis were significantly associated with lower mean improvement (2.9 vs. 5.6; P=0.04 and 2.3 vs. 5.3; P=0.01, respectively). A non significant association with scarce nasal obstruction improvement was present in older aged patients, in patients other than students and in active and passive smokers. Our data enrich the general knowledge on radiofrequency treatment of turbinate hypertrophy identifying the rate of long-term efficacy of radiofrequency treatment as perceived by patients and focusing on several risk factors involved in patient prognosis after treatment.

Congenital nasal pyriform aperture stenosis: A rare cause of nasal airway obstruction in a neonate

Congenital nasal pyriform aperture stenosis (CNPAS) is a rare cause of nasal airway obstruction that clinically mimics choanal atresia, but needs to be differentiated from the latter because of the widely divergent modes of management. We present a case of CNPAS, to highlight the importance of recognizing the classic signs of CNPAS on cross-sectional imaging.

Dysgenesis of the middle turbinate: A unique cause of nasal airway obstruction

Abstract : We present a unique case of nasal airway obstruction resulting from dysgenesis of the middle turbinate that has not been previously described. A 33-year-old woman presented to our clinic with a long history of right nasal airway obstruction refractory to medical management with nasal steroid sprays and antihistamines. She denied both epistaxis and rhinodynia, and had no history of nasal surgery. Additionally, she had never been nasally intubated for any other surgical procedure and had no history of nasal manipulation or trauma to the face. Nasopharyngoscopy demonstrated the absence of a normal middle turbinate (MT) and an obstructing mass in the posterior right nasal cavity that completely occluded the right choana (Fig 1). A computed tomography (CT) scan of the paranasal sinuses revealed a pedunculated nasal mass occurring at the posterior attachment of the malformed right MT (Fig 2). Clinical biopsy specimens were conclusive for benign respiratory mucosa, and the patient consented to operative removal of the mass. Intraoperatively, the mass was transected at the pedicle and easily delivered through the nasopharynx into the oral cavity for removal. The mass was sectioned and noted to have a firm bony rim, with a fluid-containing mucocele in the center. The patient had complete resolution of her symptoms postoperatively, and three months later she remained asymptomatic and without recurrence. This case report has been approved by the Institutional Review Board of Wilford Hall Medical Center (FWH20080139N). Patient consent for publication has been obtained by the authors.

Comparison of ultrasound turbinate reduction, radiofrequency tissue ablation and submucosal cauterization in inferior turbinate hypertrophy

Chronic nasal obstruction owed to chronic hypertrophic rhinitis is a common cause of nasal airway obstruction. In cases unresponsive to conservative treatment, various surgical techniques are commonly performed, but the issue of the optimal surgical procedure is still controversial. The objective of the present study was to evaluate the effectiveness and safety of ultrasound treatment of the hypertrophied inferior turbinates, which is a technique recently applied in rhinologic surgery. We aimed, also, to compare this method with the radiofrequency cold coblation turbinate reduction and the traditional submucosal monopolar inferior turbinate cauterization. We studied prospectively 60 patients with chronic hypertrophic rhinitis of nonallergic etiology, who underwent different surgical methods of turbinate reduction, divided into two groups: (1) in 30 patients, inferior turbinate volume reduction using ultrasound procedure on the left side and monopolar diathermy on the right was performed; (2) in 30 patients, radiofrequency coblation technique on the left side and ultrasound turbinate reduction on the right side was undertaken. Subjective evaluation of nasal obstruction and pain was performed using visual analog scales and objective evaluation of the surgical outcome was obtained using active anterior rhinomanometry and acoustic rhinometry. Examinations were performed preoperatively, and 1, 3 and 6 months after surgery. Both subjective and objective evaluation showed significant postoperative improvement in all cases. The best results were obtained with the ultrasound procedure, and second with the radiofrequency technique. The least improvement was observed in the electrocautery group, although its results did not differ significantly from the radiofrequency group. It may be, thus, concluded that ultrasound turbinate reduction is an effective and safe procedure for the management of chronic hypertrophic rhinitis, in patients failing to respond to medical treatment. Using this method, better results were obtained in decreasing subjective symptoms and nasal obstruction, in comparison with radiofrequency and electrocautery.

Nasal airway obstruction: allergy and otolaryngology perspectives

Diagnostic test preferences and management strategies for nasal airway obstruction (NAO) may vary depending on medical specialty. To discern current attitudes and practices of different medical specialties regarding diagnostic and management strategies for patients with NAO. Cross-sectional survey of all practicing otolaryngologists and medical allergists in Wisconsin and parts of northern Illinois (N = 268). Survey participants were asked to rank the tests they most commonly perform to differentiate causes of NAO and to rank the diagnostic tests they believed were most sensitive and specific (criterion standard) for NAO. The second portion of the survey provided 3 distinct patient scenarios, and participants were surveyed on their treatment plans. The survey response rate was approximately 50% for both specialties. Nasal endoscopy was the most common diagnostic test for otolaryngologists vs allergists (58% vs 2%, P < .001), and allergy testing was most commonly used first by allergists (92% vs 0%, P < .001). Nasal endoscopy was considered the criterion standard for evaluating NAO by 70% of otolaryngologists vs 29% of allergists (P < .001), although nasal endoscopy was ranked in the top 3 for both specialties without a statistically significant difference. Patient scenario responses, however, demonstrated no statistically significant differences between the specialties. Differences were demonstrated in the diagnostic workup preferences and perceptions of the criterion standard for NAO between the 2 medical specialties. Specialty bias, practitioner comfort level, and patient selection likely accounted for differences in responses. However, patient management decisions, medical or surgical, seemed to be similar between the specialties.

Functional tension nose as a cause of nasal airway obstruction

Objective The purpose of this prospective study was to evaluate the influence of functional tension nose in nasal obstruction and to discuss its frequency and management. Methods Over the years 2000–2006, 153 patients underwent revision operation for nasal obstruction in our rhinoplastic center. Twenty-two of them (14.37%) suffered from functional tension nose. All 22 patients refused rhinoplasty during primary septoplasty. Sixteen of them had a kyphotic nose and the rest six cases suffered from hanging columella (drooped nose). Eighteen of them underwent primary rhinoplasty in combination with caudal diminution under general anesthesia. The other four patients refused rhinoplasty, and under local anesthesia their tip was deprojected and reprojected. Results Marked improvement in nasal airflow was noted at the most recent follow-up evaluation in 20 patients out of 22 (90.91%). The mean length of follow-up was 8 months (ranging from 4 to 12 months). All follow-up results were based on office examination and pre- and post-operative computer-assisted rhinomanometry evaluation. In only two cases results were not efficient enough. Conclusion Our study strongly suggests that tension nose is a usual misdiagnosed cause of nasal obstruction. This problem is concealed under a “kyphotic”, “big”, or “pinocchio” nose. Usually the functional defect is spontaneously corrected during conventional rhinoplasty. However, tip should be deprojected and reprojected in cases where the patient refuses cosmetic intervention and surgeon tries to resolve his functional problem.

Radiofrequency volumetric tissue reduction for treatment of turbinate hypertrophy in children

Inferior turbinate hypertrophy is one of the most common causes of nasal airway obstruction in children. Medical treatment often produces very little improvement. Radiofrequency therapy has recently been shown to be safe and effective in volumetric tissue reduction of the turbinates in adults, but no report has been published about its use in children. We prospectively evaluated the safety and effectiveness of radiofrequency volumetric tissue reduction (RVTR) for the treatment of nasal obstruction caused by inferior turbinate hypertrophy in children. We followed up 93 children less than 9 years of age who underwent RVTR over 12 months. This surgery was performed with other procedures, such as tonsillectomy with or without grommet insertion (57 patients), tympanoplasty (10 patients), or grommet insertion alone (26 patients). Clinical examination, a medical questionnaire, and scores recorded pre- and postoperatively using Gertner-Podoshin plates were used to assess treatment outcomes 1 month, 6 months and 1 year after surgery. No adverse effects were encountered. One primary bleed due to tonsillectomy was the only complication in this group. Eighty-seven children (94%) had significantly improved nasal breathing postoperatively. The results of this study demonstrate that RVTR is a safe, effective method for the treatment of turbinate hypertrophy in children. In addition, our data demonstrates good patient acceptance over a period of 1 year.

Wyniki odległe konchoplastyki z użyciem plazmy argonowej (APC)

Interior turbinate hypertrophy is one of the major causes of nasal airway obstruction. Medical treatment often produces insufficient improvements. In these cases, surgical reduction of inferior turbinates can be proposed. Authors analyzed long-term results of argon plasma coagulation (APC) for inferior turbinates reduction in patients with chronic nasal obstruction. Rhinomanometric parameters, clearance of saccharine test results and cytological examination were statistically analyzed in 70 patients after 3 month and in 47 after 12 month after surgery. Five patients received a second operation. Only patients with first degree in T/S (turbinate/septum) nasal septum deviation were enrolled in both groups. Every patients were treated ineffectively with nasal drops. All patients received topical anesthesia. The procedure of APC were easy to perform end we did not experience postoperative bleeding. Rhinomanometric measurement demonstrated a significant nasal flow at 3 and 12 month after APC. Before 3 and 12 month after surgery the values for resistance shoved significant difference. There were no changes in saccharine transit - time during the follow-up period. At 3 postoperative month, the nasal stuffiness had improved 62 (88%) patients. At 12 month after surgery, the nasal stuffines had improved 34 (73%) patients. APC was shown to effectively reduce the symptom of nasal obstruction without any complications. Argon Plasma Coagulation should be an alternative method in treating the patients with hyperplastic inferior turbinate.

El colgajo en “J” de la crus lateral del cartílago alar en el tratamiento del colapso de la válvula nasal

IntroductionNasal valve collapse is a common cause of nasal airway obstruction. Although many techniques have been devised to treat this problem, the outcomes of most of them have been disappointing. The aim of this study is to report our experience using the lateral crural Jflap repair to correct the nasal valve collapse. This technique is based on a new view of the structural etiology of nasal valve collapse and it offers excellent functional and aesthetic outcomes Material and methodsWe present a retrospective study of 19 patients diagnosed of nasal valve collapse that underwent lateral crural J-flap repair from 2003 to 2005 Results28 lateral crural J-flap repairs were made. Six patients underwent concomitant nasal surgery. Mean follow- up was 428 days All the patients have reported improvement of the subjective sensation of inspiratory collapse and there has been no noticeable decrement in benefit over time. No complications due to the procedure were observed ConclusionThe lateral crural J-flap repair is an effective treatment for nasal valve collapse with minimal morbidity and a high success rate