Assessment of Pliability and Elasticity of the External Nasal Skin in Patients With Unilateral Nasal Valve Collapse: A Static Biomechanical Evaluation

The Relationship Between Lateral Nasal Wall Collapse and Nasal Obstruction

OBJECTIVES

In clinical practice, lateral nasal wall collapse during forced inspiration is widely regarded as a sign of nasal obstruction or criterion indicating nasal valve surgery. This study aims to evaluate the relationship between the degree of lateral nasal wall collapse and subjective nasal obstruction. In addition, factors related to lateral nasal wall collapse were also investigated.

METHODS

In this study, lateral nasal wall collapse is determined by the degree of lateral nasal wall triangle (LNWT) area reduction on frontal view during forced inspiration compared to quiet inspiration. LNWT area ratio of the patient and control groups was compared. The relationship between the lateral nasal wall collapse and clinical factors including symptom scores, nasal valve angles, skin thickness were evaluated.

RESULTS

The average LNWT area ratio of the patient (n = 24) and control groups (n = 27) was 0.96 and 0.83 respectively (P = .001). Symptom score (NOSE and VAS) is not related to the degree of lateral nasal wall collapse. Moreover, nasal valve angle and skin thickness were also not related to the degree of lateral nasal wall collapse. In 14 of the 19 patients, the more obstructed side corresponded to the side of narrower nasal valve angle, and 5 were not.

CONCLUSION

Lateral nasal wall collapse is not related to a patients' nasal obstruction.

[External and internal nasal valve. Diagnostic and treatment methods for dysfunction]

The purpose of the work is the analysis of diagnostic methods of nasal valve dysfunction according to Pubmed database and national medical journals during the period from 1997 to 2019. A brief analysis of the definition of the zones of the external and internal nasal valve, diagnostic methods, including external nasal dilators, spiral computed tomography, assessment of the degree of displacement of the nasal wing using various aspirators is given. Various methods for treating nasal valve dysfunction, such as external and internal dilators, strengthening the nasal wings, suture techniques, expanding the edge of the pear-shaped hole, implantation of absorbable polymers into the side wall of the nose are critically evaluated. Our own original correction method is described for dysfunction of the external nasal valve caused by the vertically located legs of the inferior lateral cartilage.