Nasal Valve Surgery

Abstract

The portion of the nose lying most anteriorly offers the greatest resistance to the passage of air into the airways and is termed the “nasal valve area” (“NVA”). For the nose to function properly, this valve needs to maintain its patency. A slight change in function may lead to obstruction to the passage of air through the nose and subsequent breathing problems. The NVA comprises three distinct regions: the interior and exterior nasal valves (INV and ENV) and the intervalve area (IVA) lying in between. The most narrow portion of the anterior airway in the nose is formed by the INV. Its boundaries are defined by the head of the inferior turbinate (i.e., the anterior portion of the turbinate), the septum and the caudal part of the upper lateral cartilage. The ENV is found caudally with respect to the INV, being bound by the piriform aperture, the lower lateral cartilage and the adjoining entities and the caudal portion of the septum. The IVA defines a region between internal and external valve areas and found just to the lateral aspect of the lateral crura in the lower lateral cartilages, in other words, from a surface anatomy viewpoint, in the same location as the supra alar crease. That the lower lateral cartilages and points of attachment are highly significant in the correct functioning of the nasal valve should be apparent. In this chapter, we discuss nasal valve surgery.