A new technique for functional surgery of the nasal valve area

Nasal valvular obstruction is a neglected and disregarded clinical entity in current practice. Rhinomanometry and nasal endoscopy allow a better evaluation of the degree and the site of the stenosis. The distinction between nasal valve and nasal valve area is fundamental in surgical practice. Valvular disturbances are often induced or aggravated by rhinoplastic procedures due to scar tissue formation in the region of the nasal valve area and/or to excessive resection of supporting cartilaginous structures. Routine septal surgery is often followed by sequelae in the valve area structures. The treatment of valvular disturbances is basically surgical. A systematic surgical approach should comprise the structures of the nasal valve area as well as the structures functionally related to it. After a brief review of the techniques described in the literature, the authors present an original corrective technique for the valve area deformities, performed through the hemitransfixion incision. This technique results from previous experience founded on Cottle's surgical philosophy. This technique assures the correction of the valve area deformities as well as the performance of surgical manoeuvres extended to the osteocartilaginous pyramid and the nasal cavities. It is therefore possible to properly correct the areas of resistance and to re-establish adequate functional relationships between the various parts.