A systematic approach for the management of dynamic external nasal valve collapse : (alar collapse)‎

الملخص EN

Background/Am : dynamic external valve collapse (Alar collapse) was believed to be secondary to structural weakness of the alar framework.

It has also been suggested that unilateral or bilateral alar collapse could be secondary to internal nasal valve collapse.

We aimed to assess the effectiveness of internal valve surgery on the improvement of Alar collapse.

Materials and Methods : we retrospectively reviewed the notes of 14 patients presented with unilateral or bilateral alar collapse in the ENT outpatient department, Freeman Hospital in the period between September 2003, and December 2006.

We performed septoplasty + M Pasty of the nasal valve at the side of the alar collapse with or without batten grafts to the upper lateral cartilage.

Subjective improvement was assessed with a visual analogue scale.

Results : we included 10 males and 4 females ranging in age from 27 to 65 years (average age, 46 years).

The alar collapse was successful cured with the valve surgery in all the patients.

There was statistical significant improvement in the nasal airway postoperatively.

Conclusion : lard collapse, in patients who have not had previous rhinoplasty, is most likely to secondary to internal nasal valve obstruction.

Surgical correction of the internal nasal valve obstruction is successful in improving subjective nasal obstruction and preventing alar collapse in patients without previous surgery.

Success of the procedure is predicted by meticulous clinical examination and the use of the modified Cattle's test to employ the appropriate surgical technique.

The use of the nasal dilators preoperatively is essential to select the patients and to provide the patients with a realistic expectation of the surgical intervention.