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Surgical Management of the Internal Nasal Valve: A Review of Surgical Approaches

  • Review
  • Rhinoplasty
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Nasal valve collapse is relatively common with a lifetime prevalence of up to 13%. Etiologies include prior rhinoplasty, other surgical procedures, facial paralysis, congenital defects, trauma, and aging. Internal nasal valve collapse leads to impairment of nasal breathing, which significantly disturbs quality of life. Many approaches to increase the cross-sectional area of the internal nasal valve have been described.

Results

The main categories reviewed in this article are cartilage grafting, implants, and suture suspension techniques. Cartilage grafting techniques include alar batten graft, butterfly graft, spreader graft, autospreader graft, and alar composite graft. The implant technique includes the titanium butterfly implant. The suspension techniques included are the transconjunctival approach, Mitek bone anchor, flaring suture, lateral pull-up, and piriform rim suspension. Surgeons must carefully consider functionality, cosmesis, and technical difficulty when selecting an approach.

Discussion

We review indications, general approach, benefits, and considerations for a number of available techniques to help surgeons decide what approach might be best suited to the individual patient.

Level of evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Author notes

  1. Margaret A. Sinkler and Chase J. Wehrle have contributed equally.

Authors and Affiliations

  1. Medical College of Georgia, Augusta, GA, 30912, USA

    Margaret A. Sinkler, Chase J. Wehrle, Joseph W. Elphingstone & Emma Magidson

  2. Department of Plastic Surgery, Medical College of Georgia, Augusta, GA, USA

    Edmond F. Ritter

  3. Department of Otolaryngology, University of Florida College of Medicine, Gainesville, FL, USA

    Jimmy J. Brown

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  1. Margaret A. Sinkler
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  2. Chase J. Wehrle
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  4. Emma Magidson
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Correspondence to Margaret A. Sinkler.

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Sinkler, M.A., Wehrle, C.J., Elphingstone, J.W. et al. Surgical Management of the Internal Nasal Valve: A Review of Surgical Approaches. Aesth Plast Surg 45, 1127–1136 (2021). https://doi.org/10.1007/s00266-020-02075-5

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