Hey. I have had a rhinoplasty 13 years ago, and didn't suffer for any sugnificant breathing problems untill two years ago. One day, I felt that the lateral wall is collapsing, and from than on I'm suffering from dianmic nasal obstruction in the right side. It's possible to see that there was an oversection. The nose is too narrow. I have attached a sinus x-ray in which it's possible to see that the right side is too narrow. Is it reversible? Thank you for answering me.
Nasal Valve Insufficiency. Breathing Problems 2 Years Post-Op, What Should I Do? (photo)
Doctor Answers (6)
Nasal valve collapse
Collapse of the nasal valves is typically due to cartilage (as opposed to bone) and would not show on x-rays - typically cartilage grafting is needed for correction
Nasal valve insufficiency repair
Having nasal obstruction on the one side of your nose can be repaired with spreader grafts taken from the septal cartilage. It is also important to make sure that your septum is straight and your turbinates are well lateralized. Make sure your allergies are under good control. Spreader grafts will make the collapsed side wider, straighter and more stiff. You may need bilateral spreader grafts since there was resection on both sides. Plain x-rays will not help with this analysis.
Nasal Valve Narrowing
Nasal valve narrowing may occur after a reduction rhinoplasty. Breathing can be improved with placement of cartilage grafts (called spreader grafts) which open that narrow valve. Depending on size and placement, both functional and cosmetic improvement can be achieved.
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Nasal valve surgery
Sometimes with rhinoplasty surgery the valve can collapse. This can often be treated with cartilage grafts.
Lateral wall collapse after rhinoplasty is technically called a narrow nasal valve
Nasal valve narrowing after rhinoplasty is all too common. This comes from weakening of the cartilage attachments, weakening of the cartilage as well as narrowing from reducing a large nasal hump. This can often be restored by the use of grafts called spreader grafts, or sometimes other surgical maneuvers. I actually use spreader grafts in over 90% of my primary rhinoplasties to reduce the chance of this happening in the first place.
This really cannot be diagnosed by a standard X-ray since it is from cartilage, which does not show up well on an X-Ray. However, I am currently conducting a study to look at the nasal valve on CT scans.
Nasal valve collapse
A common cause of nasal valve collapse is surgery. If the nasal valves are not supported or respected, nasal valve insufficiency may occur. This typically is noticed soon after the procedure, but can take longer. Cartilage resorption or abnormal scarring may also lead to nasal valve issues. Plain X-rays are not a good tool to evaluate the nasal valve as cartilage does not appear on X-ray. Nasal valve collapse is diagnosed by exam. You may need a revision to support the nasal valve in order to breathe better. A thorough evaluation is necessary prior to making a definitive surgical decision.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.