The sensation of your nostrils collapsing inward when you inhale is a common and frustrating experience. This obstruction, especially during deeper inhalation, can significantly impair quality of life, affecting sleep, exercise performance, and general comfort. People often describe it as feeling perpetually congested or blocked, even when the nose is clear of mucus. This difficulty with airflow is known medically as nasal valve collapse, which represents a structural weakness that restricts the movement of air.
The Mechanics of Nasal Collapse
The physical collapse happens in the nasal valve area, the narrowest point of the nasal airway. This area regulates the majority of airflow resistance into the lungs. The collapse occurs because of the Bernoulli effect, where fast-moving air creates an area of lower pressure. When you inhale quickly, the air speed increases, and the resulting negative pressure pulls the soft, unsupported tissues inward.
Nasal Valve Collapse is categorized by the location of the weakness. External nasal valve collapse, or alar collapse, involves the nostril’s sidewall, supported by the lower lateral cartilage. This type is often visibly noticeable as the nostril rim sucks inward during inspiration. Internal nasal valve collapse involves the area further inside the nose, where the upper lateral cartilage meets the septum, presenting as a pinching in the middle third of the nose. Both forms result in symptoms like chronic nasal stuffiness and loud breathing, including snoring.
Structural Reasons for Airway Instability
The inability of nasal tissues to withstand the negative pressure of inhalation stems from structural weakness in the underlying cartilage. This weakness can be due to several factors.
Inherent anatomy or congenital predisposition can result in cartilage that is naturally thin or shaped poorly, providing inadequate support. A deviated septum, where the wall separating the nostrils is crooked, also contributes to collapse by reducing space and weakening support on one side.
Trauma to the nose, such as a fracture or facial injury, is a frequent cause, as it can damage or displace the delicate cartilaginous framework. Previous nasal surgery, particularly rhinoplasty, can also compromise structural integrity if too much cartilage is removed or if the remaining support is insufficient (an iatrogenic cause). Furthermore, age-related changes weaken connective tissues, leading to a drooping of the nasal tip and a loss of rigidity in the lateral nasal walls, increasing the likelihood of collapse.
Immediate and Non-Invasive Relief Strategies
Immediate relief involves methods that mechanically stabilize the weakened parts of the nose. External nasal dilator strips adhere to the outside of the nose and use a spring-like action to gently pull the nostrils open, counteracting the inward suction. Correct placement is important, with the strip positioned across the bridge of the nose just above the collapsing area.
Internal nasal dilators are small, flexible silicone devices inserted into the nasal vestibule to provide support from within. These devices brace the lateral nasal wall and are helpful for nighttime use to reduce snoring and improve sleep. Positional changes during sleep, such as elevating the head or sleeping on the back, may also temporarily alleviate symptoms by reducing pressure on the nasal structures.
To gauge the extent of the problem and see if mechanical support helps, you can perform the Cottle Maneuver at home. Place one or two fingertips on your cheek beside the nose, near the collapsing area, and gently pull outward. If breathing significantly improves while maintaining this tension, it suggests the obstruction is in the nasal valve. This simple test indicates that relief is possible by externally widening the affected area.
Professional Treatment and Surgical Options
When non-invasive methods do not provide sufficient relief, consulting with an Ear, Nose, and Throat (ENT) specialist is the next step for a formal diagnosis. The specialist confirms the location and severity of the collapse using the Cottle Maneuver and a detailed internal examination. Treatment options beyond external support focus on reinforcing the weak cartilage to provide permanent structural stability.
Professional intervention includes less invasive procedures:
- Specialized implants, sometimes made of titanium, are placed beneath the skin to act as an internal splint, supporting the collapsed valve area.
- Radiofrequency treatments use controlled energy to tighten and stiffen the soft tissues of the nasal valve, which helps prevent inward movement during inhalation.
For a comprehensive and permanent solution, surgical reconstruction of the nasal valve is often recommended. Surgeons use cartilage grafts, typically harvested from the patient’s own septum, ear, or rib, to reinforce the weakened areas. Techniques include:
- Spreader grafts are placed between the septum and the upper lateral cartilage to widen the internal nasal valve angle.
- Alar batten grafts are thin pieces of cartilage placed along the sidewall to strengthen the lower lateral cartilage, treating external collapse.
These procedures aim to permanently restore the structural integrity of the nasal airway.