The nasal valve is a narrow region within the nose that plays a central role in regulating airflow during breathing. It controls the amount of air entering the respiratory system. Proper function is important for efficient nasal breathing, which helps to filter, warm, and humidify inhaled air before it reaches the lungs.
Where is the Nasal Valve?
The nasal valve is not a singular structure, but an area composed of several anatomical components. It is divided into two main parts: the external and internal nasal valves. The external nasal valve forms the nostril opening and is defined by the nasal rim, the nasal floor, the columella (the skin separating the nostrils), and the lower lateral cartilage.
Moving deeper inside the nose, approximately 1.5 centimeters from the nostril, lies the internal nasal valve. This area represents the narrowest part of the nasal cavity. It is formed by the nasal septum, the upper lateral cartilage, and the inferior turbinate. Both external and internal nasal valves rely on the strength and integrity of their cartilaginous structures to maintain their shape and function.
How the Nasal Valve Works
The nasal valve regulates airflow into and out of the nasal passages during respiration. It dynamically adjusts its cross-sectional area to manage airflow, ensuring efficient breathing. This regulation helps maintain the patency, or openness, of the airway, preventing its collapse.
This area also serves as the main site of airflow resistance within the nose. This resistance is beneficial as it helps to warm, humidify, and filter the inhaled air, protecting the deeper respiratory tract from particles and dry air. The coordinated action of the nasal valve components ensures air is processed optimally before reaching the lungs.
When the Nasal Valve Doesn’t Work Properly
When the nasal valve does not function correctly, often due to weakness or obstruction, it can lead to nasal valve collapse or insufficiency. This dysfunction can impede nasal breathing and affect quality of life. The collapse can be static, meaning the airway is always narrowed, or dynamic, where it collapses inward primarily during inhalation.
Several factors can contribute to nasal valve issues, including previous nasal surgery, such as rhinoplasty, which can sometimes weaken supporting cartilages. Trauma, the natural aging process leading to tissue weakening, or a genetic predisposition to weaker cartilage can also play a role. A deviated septum, where the wall between the nostrils is displaced, can also contribute to the problem.
Individuals experiencing nasal valve dysfunction often report difficulty breathing through one or both nostrils, a sensation that may worsen during physical activity or when lying down. Other common symptoms include persistent nasal congestion, a feeling of blockage, increased snoring, and reliance on mouth breathing, which can lead to a dry mouth. In some cases, an external nasal valve collapse might be visibly noticeable as the nostril collapses inward during inhalation.
Identifying and Addressing Nasal Valve Problems
Identifying nasal valve problems typically begins with a physical examination by a healthcare provider. The provider may also use a Nasal Obstruction Symptom Evaluation (N.O.S.E.) questionnaire to assess the severity of a patient’s symptoms and their impact on daily life. A common in-office test is the Cottle maneuver, where the cheek is gently pulled outward to temporarily widen the nostril or nasal valve area. If breathing improves with this maneuver, it suggests the nasal valve area is a contributing factor to the obstruction. Further evaluation might involve nasal endoscopy or CT scans to visualize the internal structures.
Addressing nasal valve issues involves both non-surgical and surgical approaches, depending on the underlying cause and severity. Non-surgical options include external nasal strips or internal nasal dilators, which help physically open the nasal passages. For minor inflammation, over-the-counter nasal decongestants may offer some relief.
When non-surgical methods are insufficient, surgical interventions aim to stabilize and widen the nasal valve area. Common surgical techniques involve grafting, where cartilage from the patient’s own septum, ear, or rib is used to reinforce the weakened structures. Implants, such as absorbable devices like Latera®, can also be used to provide internal support. Newer, minimally invasive procedures like radiofrequency treatment (VivAer®) reshape nasal tissue using controlled energy to improve airflow without incisions. Often, nasal valve repair is performed in conjunction with other procedures, such as septoplasty to correct a deviated septum, to optimize nasal airflow.