Functionally Crippled Nose

Abstract

Nasal obstruction is a common presenting symptom of patients seen by primary care physicians, otolaryngologists, and facial plastic surgeons. A variety of treatment strategies, both surgical and nonsurgical, have been used with success in improving nasal obstruction and quality of life. In a subset of patients, many of whom have either attempted these common treatment strategies or are intolerant of them, nasal obstruction remains a significant symptom. In these patients, there may be an identifiable problem, but it is simply not repairable or there is no identifiable anatomic issue. The management of these patients is discussed in this article, with an emphasis on a sensitive approach that takes into consideration a patient's mental health. While the need for diagnostic testing is generally not necessary for most cases of nasal obstruction, endoscopy and imaging should be considered in these patients. Validated patient-reported outcome measures are particularly helpful in providing an objective measure to a patient's frustrating symptoms. A variety of medications can be either contributory to the patient's symptoms or therapeutic if used appropriately. A variety of surgical interventions can also result in a functionally crippled nose and diagnoses including nasal valve stenosis, septal perforations, and empty nose syndrome are discussed. Importantly, further surgical interventions may not be appropriate if a deformity is minimal, and a surgeon should resist the temptation to proceed with surgery in those situations.

The first report of using endoscopy to evaluate the structure of the internal nasal valve and the measurement of internal nasal valve angle value in Vietnamese people

“…The internal nasal valve is the narrowest portion of the nasal cavity, located approximately 1.3 cm from the nares, and corresponds to the region under the upper lateral cartilages, bound medially by the dorsal septum, inferiorly by the head of the inferior turbinate, and laterally by the upper lateral cartilage (Murthy et al, 2013;Rhee et al, 2010). The average angle of the INV in a Caucasian and Most, 2020;Schuman and Senior, 2018). The nasal endoscopic evaluation method is a cost-effective way to examine the internal nasal valve angle and is easy to access without side effects.…”

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“…The INV is a noticeable area for ORL surgeons to correctly evaluate before rhinoplasty and/or sep- and Most, 2020;Schuman and Senior, 2018). The nasal endoscopic evaluation method is a cost-effective way to examine the internal nasal valve angle and is easy to access without side effects.…”