. Posted in SURGERY

Nasal valve surgery is for those who have scarring and/or collapse of their nasal valves. This usually occurs after trauma or as a result of infection and/or previous surgery. When the nasal valve is collapsed or scarred, breathing is compromised significantly. These defects tend to be very difficult to repair and most surgeons do not even want to deal with these

defects because of the complexity. The nasal valve area is narrow and

scarring tends to recur. Furthermore, when collapse of the nasal valve is a result of a cartilaginous defect in the area of the nasal valve, grafting may be required.

Reconstruction of this area requires significant skill. Flaps may need

to be advanced or rotated to prevent crimping in this area. Often this surgery can be performed under local anesthesia with sedation, by directly removing the scar tissue in the nostril, then undermining the area and placing grafts, which act similarly to a collar stay in a men’s dress shirt. When more cartilage grafting needs to be placed and rebuilding of the lower lateral cartilages needs to occur, an external rhinoplasty incision may be required.

Lifting the soft tissues off the dorsum of the nose will give the surgeon the visualization that is required to reconstruct the lower lateral cartilages when they are dehiscent (split), scarred, or totally gone. Appropriate support and removal of scar with closure of the wound is required to repair the collapsed nasal valve. Dissolvable stitches are used internally to close the incision sites, and nylon stitches are placed externally (these need to be removed in 3-7 days).

After surgery, the tip of the nose is typically swollen, more so if an external incision is necessary. There are minimal black-and-blue marks, but patients usually have some tape placed over the tip of his or her nose for a few days (up to a week) to keep the grafts from moving. Most of the swelling usually disappears after a few days to two weeks.

Patients are usually able to breathe better immediately after surgery. However, on occasion the surgeon may decide to place a stent in the nostrils, and this can cause some minor discomfort and nasal obstruction. Overall, these stents are removed in a few days to 2 weeks.

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