Will a septoplasty take care of a slight nasal valve collapse?

Question

I have a septo-rhinoplasty scheduled in a few months. I went to the doctor recently, to assess if I truly needed a septoplasty, and I found out the following information: "Because of her nasal valve dysfunction, septoplasty will not correct her breathing and I have also recommended nasal valve repair with a left spreader graft. This will reinforce and open the nasal valve." Will a septoplasty surgery address nasal valve collapse? Or is that a completely different procedure?

Edwin Kwon, MD, FACS · Answer

From your description, it sounds like you have what's known as a narrow internal valve angle.  Your surgeon probably did what's called a Cottle Test, where he had you breath while tugging on your cheek to spread your internal valve open.  A narrow internal nasal valve angle produces turbulent airflow and thus limits the amount of air that can pass through.

Septoplasty does not correct a narrow internal valve angle.  Your surgeon mentioned placing a spreader graft (which they will get from your septum) and place it between your septum and your upper lateral cartilage to open up your internal nasal valve angle.  This will open up the air passage and allow more laminar flow of air, improving your breathing.

Another factor that can limit breathing is external valve collapse.  This is when you take a rapid breath in through your nose and the nostrils collapse in.  This requires an alar rim graft to splint open the nostrils and prevent them from collapsing.

But from your description above, it is likely that your surgeon is looking to address your narrow internal nasal valve angle.

Scott Trimas, MD · Answer

You are correct in that sometimes a septoplasty alone can correct nasal valve obstruction, but not collapse. If you have some blockage and it is high up in the nasal valve region it could also be the result of a highly deviated septum or it may be due to narrowing and/or collapse that would require a spreader graft. I would discuss your concerns with your surgeon as to why he/she recommends a spreader graft and go into detail with you as to why this portion of the surgery is necessary.

Ronald J. Edelson, MD · Answer

Nasal valve collapse usually is the result of prior surgery but you don’t mention if you had any. If you’re not sure about the nasal valve part you should get other opinions. It had been my experience that spreader grafts are often overused so it’s worth getting other opinions.

Jeffrey Joseph, MD, FACS · Answer

Thanks for the question.  In most practices, these two procedures are done together, as  septal cartilage is used as the graft material for the spreader graft.  A septoplasty can help breathing, but if you have a middle third issue (pull your cheek out to see if you breathe better) a spreader graft is most often needed.

William Portuese, MD · Answer

A septoplasty will help improve a deviated septum and improve airflow through the nose. Spreader grafts are used for nasal valve collapse. They are 2 complete separate procedures, however both can be performed for functional purposes simultaneously on one anesthesia

Will a septoplasty take care of a slight nasal valve collapse?

Answers (5)

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