Nasal valve collapse can make comfortable nasal breathing feel almost impossible. This oft- undiagnosed condition significantly impairs your ability to breathe efficiently through the nasal passages, which can often trigger further distressing symptoms like increased heart rate, poor sleep, anxiety, and more.
The nasal valve, a critical anatomical structure within the nasal cavity, acts as the nose’s primary regulator of airflow. When this valve weakens or collapses, it creates a physical bottleneck that severely restricts airflow. Not getting enough air when breathing through the nose can manifest in a spectrum of troubling sensations and negatively impact quality of life. Fortunately, contemporary medical advancements offer effective treatment modalities designed to restore optimal nasal function.
Symptoms
Nasal valve collapse presents with a range of uncomfortable, sometimes debilitating, symptoms. If you are experiencing one of the following, you may be a candidate for targeted treatment:
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- Significant Difficulty Breathing Through the Nose – This is the most prevalent symptom of nasal valve collapse, frequently likened to breathing through a straw.
- Persistent Nasal Congestion or Stuffiness – Even in the absence of infections or allergic rhinitis, individuals may experience a constant feeling of nasal blockage.
- Nasal Resistance During Exercise – Active individuals commonly find it increasingly challenging to breathe during periods of physical activity or exercise.
- Snoring or Obstructive Sleep Apnea – Nasal valve collapse can contribute to sleep-disordered breathing, including snoring and obstructive sleep apnea.
- Recurrent Epistaxis (Nosebleeds): In some cases, the dryness and irritation caused by restricted nasal airflow can predispose patients to recurrent nosebleeds.
- Dependence on External Nasal Dilators: Individuals with nasal valve collapse frequently become reliant on nasal strips or other external dilators for even a slight improvement in nasal airflow.
Treatment
If you’re suffering from any of the above symptoms, a comprehensive clinical evaluation is needed to determine the potential contribution of nasal valve collapse. Each treatment option is tailored to the severity of nasal valve collapse and the specific clinical presentation of the patient. Here are the most common treatment options currently available:
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VivAer Treatment:
This non-invasive, office-based procedure uses low-temperature radiofrequency energy to gently remodel the lateral nasal wall, effectively widening the nasal valve and improving airflow. A four-year clinical trial for the VivAer treatment found that 96% of patients experienced substantial improvement in nasal breathing, 96% reported sleeping better, and 93% could breathe better during exercise. VivAer treatment causes minimal discomfort, and most patients can go about their day normally after the procedure.
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Pharmacological Management:
For mild to moderate cases of nasal valve collapse, topical or systemic medications may be recommended. Nasal corticosteroids or decongestants might be prescribed by your physician to reduce mucosal inflammation and improve nasal patency. However, medications, while providing relief for symptoms, cannot repair the structural causes of nasal valve collapse.
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Surgical Intervention:
In the most severe cases of nasal valve collapse or when other more conservative treatments prove inadequate, surgical reconstruction of the nasal valve may be necessary. Surgical techniques include cartilage grafting, suture suspension, and other reconstructive procedures help restore optimal nasal function. Most patients will want to avoid these types of surgical interventions at all costs, as they can potentially impact the outward appearance of the nose.
Nasal valve collapse can severely impact day-to-day functioning by making nasal breathing difficult, and most often, the condition won’t improve with medications due to the underlying structural issues. If you think you may have nasal valve collapse, it is important that you be seen for a clinical examination here at the Southern California Sinus Institute. Contact Dr. Cohen’s office today to schedule a consultation to find out your treatment options and a path forward to better breathing.
FAQ
What causes nasal valve collapse?
Nasal valve collapse occurs when the airway gets blocked due to coagulated tissue. This can happen because of personal anatomy, aging, injury, or previous surgeries. Additionally, people with a deviated septum and/or who’ve undergone rhinoplasty have an increased risk for nasal valve collapse.
Are there different types of nasal valve collapse?
Nasal passages have two key areas that control airflow: the internal and external nasal valves. The internal valve, located deeper inside the nose, is the most frequent site of collapse. The external valve, at the nostrils, is less commonly affected, but when it does collapse, patients can often visibly see the nostrils pinching inward upon inhaling. Both valves are designed to help regulate breathing, but due to their different locations and supporting structures, they collapse in distinct ways.
How is nasal valve collapse diagnosed?
To accurately diagnose and treat nasal valve collapse, we’ll begin with a comprehensive discussion of your medical history and specific symptoms you’re experiencing. We may use a questionnaire, like the NOSE scale, to quantify the impact these symptoms have on your daily life in the form of sleep quality, ability to exercise, and overall comfort.
Next, we’ll perform a detailed examination of your nasal passages. This may involve a nasal endoscopy, where a small camera helps us visualize the internal structures of your nose. We’ll also likely perform the Cottle maneuver. This simple test involves gently widening your nostril or cheek to see if it improves breathing, helping pinpoint the location and severity of collapse. These tests combined will give a clear picture of what’s happening and point us in the right direction of effective treatment.
How widespread is nasal valve collapse?
Nasal valve collapse is a very common reason for breathing difficulties through the nose. In fact, somewhere around 13% of the population experiences it, making the condition a frequent culprit behind nasal obstruction.
What is the prognosis for nasal valve collapse?
Nasal valve collapse can progress over time if left untreated because the supporting structures in the nose can continue to weaken. Therefore, it’s important to address the issue to prevent further deterioration.
Fortunately, the long-term outlook for nasal valve collapse is generally very positive. Surgical correction typically yields significant improvement in breathing, sleep quality, and overall well-being.