Nasal valve dysfunction: diagnosis and treatment

This article reviews the etiology and treatment options for nasal valve stenosis (NVS), a common cause of nasal obstruction. It is based on meta-analyses, published expert panel opinions, extensive literature review, and previously published results of our own clinical experience.

Diagnosis and management of NVS continue to evolve. Although most studies that describe the surgical techniques of nasal valve repair report an improvement in patient complaints, there is a paucity of controlled trials that point to the most effective method. Lack of high-grade evidence may be due to ambiguities in objectifying patient complaints, standardizing treatment, and the lack of adequate controls. Recent literature addresses these ambiguities and provides suggestions on future directives in research. There is also a trend towards minimally invasive treatments that are effective in treatment of appropriate patients.

The diagnosis of NVS is primarily based on the subjective feeling of nasal obstruction associated with specific findings on the physical examination. Patient complaints are best objectified with validated questionnaires. Treatment of this condition is typically surgical and, as is evident by the plethora of described surgical procedures, there is often no consensus as to the best choice even in patients with identical findings on physical examination.