Nasal valve suspension revisited

Nasal valve suspension (NVS) is a simple technique to correct nasal valve obstruction or collapse by providing a lateral vector of pull on the nasal sidewall. The purpose of this research was to review our experience with NVS in a cohort of patients with nasal valve collapse, including a subset of patients with facial paralysis. The objectives were to determine patient satisfaction and complication rates after NVS.

A retrospective review of patients 18 years and older who had NVS from 2003 to 2006 with a follow-up of at least 1 month was performed.

Data were collected on diagnosis, surgical outcomes, complications, and treatments required. Complications included adverse outcomes, infections, and the need for repeat surgery or treatments.

In 17 charts reviewed, 9 patients (53%) had nasal valve collapse as a result of facial paralysis, and 8 (47%) had previous nasal surgery. Follow-up ranged from 1 to 30 months, with a mean of 16.5. Moderate to complete resolution of obstruction was reported by 82% of patients, or for 88% of procedures. Sustained relief was observed in two of eight patients who had previous nasal surgery and six of nine who had no previous nasal surgery (P = .1). Infection occurred in four (24%) patients and five (21%) total suspensions and ranged from 1.5 to 7 months. Six (35%) patients experienced a loss of suspension at 6 to 22 months.

NVS is a technically straightforward, relatively reversible procedure particularly useful in the patient with facial paralysis. The efficacy is excellent in the short term yet appears to diminish with time.