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A New Technique to Manage Nasal Valve Collapse

Martyn S. Mendelsohn, FRACS; Kambiz Golchin, MMed (Sci), FRCS

Arch Facial Plast Surg. 2006;8:293-299.

Objective  To describe the new technique of alar expansion and reinforcement as a comprehensive approach to the surgical management of nasal valve collapse.

Methods  Alar expansion and reinforcement expands the narrow nasal valve and reinforces the floppy nasal sidewall. Forty-one patients underwent rhinoplastic surgery for nasal valve collapse between May 1, 2002, and April 30, 2005, using an external rhinoplasty approach; of these, 32 responded to our postoperative questionnaire. Twenty-four patients (75%) underwent primary surgery and 8 (25%) had undergone previous rhinoplasty. All patients had permanent adjustable expansion sutures. Twelve patients (38%) had an excessively floppy nasal sidewall that required a high-density porous polyethylene alar batten implant to anchor the expansion sutures. Patients underwent clinical review from 6 months to 3 years after surgery, and a telephone survey was used to evaluate their functional and cosmetic satisfaction rates.

Results  Thirty patients (94%) experienced good improvement in their nasal airway. The improvement in nasal airway patency was statistically significant (P<.001). Two patients (6%) reported no improvement. There were no complications. Cosmetic outcome was satisfactory in all 8 patients who also requested cosmetic improvement. Of the 24 patients who had surgery for nasal obstruction only, 10 (42%) rated their cosmetic appearance as better, with the remaining 14 (58%) indicating that they did not identify any significant change in their nasal appearance.

Conclusion  Alar expansion and reinforcement is a safe, reliable, and effective technique to manage nasal valve collapse.

Author Affiliations: Stuart Clinic, Sydney, Australia (Dr Mendelsohn and Mr Golchin). Mr Golchin is now a consultant otolaryngologist and facial plastic surgeon for Beacon Hospital, Dublin, Ireland.

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