What is Nasal Valve Collapse?

Nasal Valve Collapse, also known as Lateral Nasal Wall Collapse, is a condition affecting the nose, characterised by the weakening or narrowing of the nasal valves. The nasal valves are located at the middle and bottom of the nose, at either end of the first section of the nasal airway.

When these valves narrow, air isn’t able to flow freely through the nose, leading to breathing difficulties and sleep disorders such as snoring or sleep apnoea. Depending on the severity and type of Nasal Valve Collapse, the outer sides of the nose (the lateral wall) may pull inwards during inhalation.

There are two nasal valves located in each side of the nose:

External (anterior) nasal valves – These are at the bottom of the nose, near the nostrils.
Internal nasal valves – These are in the middle of the nose, part of the internal nasal airway.

Many people who are affected by Nasal Valve Collapse may not realise their breathing concerns are caused by this condition. As well as being uncomfortable, breathing difficulties can have wider-reaching effects on health and well-being:

Poor sleep – An obstructed airway can lead to sleep disorders, including snoring or sleep apnoea. This can cause fatigue, and affect concentration and immune health
Discomfort exercising – Exercising and physical activity can be made challenging due to breathing difficulties, potentially affecting physical health
Anxiety – Embarrassment around snoring or sleep apnoea may cause anxiety or affect personal relationships
Reduced quality of life – Diminished productivity and chronic tiredness may lead to a significantly reduced quality of life

If you are concerned about the symptoms of Nasal Valve Collapse, it is important to speak with an expert Consultant ENT Surgeon who can perform a thorough assessment and offer effective solutions to improve your breathing and quality of life.

Types of Nasal Valve Collapse

There are two types of Nasal Valve Collapse with different signs, depending on which nasal valve is affected:

Internal Nasal Valve Collapse

Internal Nasal Valve Collapse is caused by the narrowing of the internal nasal valve, in the mid-section of the nose. As the internal nasal valves are naturally the narrowest area of the airway in the nose, Internal Nasal Valve Collapse is the more common variant of the condition.

There are no visible signs of Internal Nasal Valve Collapse, so individuals who are affected may believe they are experiencing allergies or cold symptoms.

External Nasal Valve Collapse

Also known as Anterior Nasal Valve Collapse, External Nasal Valve Collapse involves the external nasal valve at the bottom of the nose narrowing and is less common than Internal Nasal Valve Collapse. There are more likely to be visible signs of External Nasal Valve Collapse, typically the outer walls of the nose collapsing or pulling inwards during inhalation.

It is possible to experience narrowing of both the internal and external nasal valves at the same time. The type of Nasal Valve Collapse you are diagnosed with depends on which nasal valve has narrowed more severely.

Nasal Valve Collapse can occur on one or both sides of the nose. In cases where it only affects one side, breathing is usually less significantly affected, whereas symptoms are more severe when both sides have weakened.

What are the Symptoms of Nasal Valve Collapse?

Nasal Valve Collapse symptoms can vary depending on the severity of the weakness in the nasal valve.

Nasal Valve Collapse symptoms can include:

The outer walls of the nose pulling inwards when you breathe in
Difficulty breathing through the nose, especially when lying down
Consistently stuffy nose that doesn’t improve or respond to medication, often mistaken for allergies
Regular nose bleeds
Snoring or sleep apnoea
Dry mouth, often in the morning, from compensating by breathing through the mouth
Headaches

If you have been persistently experiencing any of these symptoms and other treatments and interventions have been unsuccessful, discussing your concerns and Nasal Valve Collapse with a Consultant ENT Surgeon is a sensible step forward to understanding your condition and finding a possible solution.

What Causes Nasal Valve Collapse?

Nasal Valve Collapse is primarily caused by the weakening of the cartilage surrounding the nasal valves in the lateral nasal walls. When this cartilage becomes impaired, the integrity of the airway weakens.

There are a number of reasons the cartilage of the lateral nasal walls can weaken, causing Nasal Valve Collapse:

Deviated septum – As with many functional nasal concerns, having a deviated septum is a significant risk factor. The septum is the cartilage which runs down the centre of the nose, creating the two nostrils. When this cartilage becomes damaged or misaligned, the cartilage on the outer sides of the nose can also be affected
Genetics – The natural structure of an individual’s nose can also increase the risk of Nasal Valve Collapse. Narrow nostrils, a widened columella or an over-projected nose can all increase the risk of impairing the lateral nasal walls
Previous surgery – Previous surgery to reconstruct the nose following injury, or a Rhinoplasty, may cause the narrowing of the airway due to the repositioning of the surrounding cartilage
Injury – Having a broken nose can cause damage to the nasal cartilage, obstructing the airway
Ageing – The tissues surrounding the nasal valves can become weaker over time

In some cases, the cause of a collapsed nasal valve will be obvious, such as a previous injury. However, for others, Nasal Valve Collapse causes may be more challenging or even impossible to establish.

How to Fix a Collapsed Nasal Valve

There are several surgical and non-surgical treatments for Nasal Valve Collapse, depending on the severity of the condition and the most appropriate treatment for your concerns.

Non-Surgical Treatments for Nasal Valve Collapse

Non-Surgical treatments for Nasal Valve Collapse are a good option for patients who are experiencing mild symptoms and are looking for relief that doesn’t involve surgery.

Breathing Strips

Also known as Nasal Strips, Breathing Strips are stiff pieces of self-adhesive fabric which are placed over the nose, usually just above the nostrils. They work by supporting the lateral walls of the nose, providing temporary strength to the cartilage and holding the nasal valves and airways open.

Breathing Strips are a suitable option for individuals who find that their Nasal Valve Collapse is mild, and their breathing difficulties only affect some aspects of their life, such as:

Sleeping – Breathing Strips can keep the nasal airways open during the night, preventing snoring, and improving sleep quality
Exercise – If Nasal Valve Collapse is affecting the ability to participate in sport and exercise, Breathing Strips can be an effective and non-invasive option

There are several benefits to Breathing and Nasal Strips, which make them an appealing option:

Widely available from high street pharmacists
Portable and easily applied when required
A non-invasive treatment

Breathing Strips may not be effective for individuals who are affected by severe Nasal Valve Collapse, and as they aren’t reusable, consistent use does involve the cost of repurchasing regularly.

Nasal Valve Dilator

Similar to Breathing Strips, a Nasal Valve Dilator widens the internal nasal airway, however, it is placed inside the nostrils rather than being stuck to the outside of the nose.

Nasal Valve Dilators are small tubes made from flexible silicone which have been moulded to fit into the nostrils. Once inserted, they push against the lateral nasal walls to widen the nostrils and improve airflow.

They are usually recommended for individuals whose Nasal Valve Collapse is causing snoring and other sleep issues, and aren’t necessarily suitable for exercise.

Benefits of Nasal Valve Dilator treatment include:

They are reusable and each set can be used for a long period of time
There are a wide range of designs and shapes available making it relatively simple to find an option that suits each individual
As they provide internal support, they may be more effective than external treatments

Nasal Valve Dilators are suitable for mild Nasal Valve Collapse which is causing snoring or breathing difficulties during sleep. However, some people may find them uncomfortable to wear, and they don’t offer a permanent solution.

Nasal Valve Collapse Surgery

Surgery to treat a collapsed nasal valve is often a straightforward procedure that offers an effective and long-term solution. Surgical Nasal Valve Collapse treatments are types of Rhinoplasty surgery, which all address different areas and structures of the nose.

Septorhinoplasty

Septorhinoplasty is the most comprehensive type of Rhinoplasty surgery and addresses the internal and external structures of the nose.

By repositioning the septum and the external nasal cartilage, breathing difficulties are improved, and the outer walls of the nose are strengthened, preventing further collapsed nasal valve concerns.

Benefits of Septorhinoplasty to treat Nasal Valve Collapse include:

A comprehensive procedure which addresses multiple areas of concern in one surgery
Both functional and aesthetic concerns can be resolved
Permanent results requiring no maintenance once recovered

Septorhinoplasty is suitable for patients who are experiencing moderate to severe Nasal Valve Collapse symptoms and who are looking for a comprehensive procedure to address functional and aesthetic problems.

Septoplasty

Septoplasty surgery addresses concerns related to a deviated septum.

The surgery involves realigning and repairing the cartilage between the nostrils, reopening the airways and reducing obstruction caused by a deviated septum.

Benefits of Septoplasty as Nasal Valve Collapse surgery include:

Effectively treats Nasal Valve Collapse when caused by a deviated septum
Strengthens and improves function, without changing the external appearance of the nose
A very simple procedure which often takes less than an hour to complete
Less downtime than more involved Rhinoplasty procedures

Septoplasty is suitable for patients whose Nasal Valve Collapse symptoms are primarily the result of a deviated septum. However, for patients who require the external walls of the nose to also be strengthened may find that this is not a comprehensive enough approach.

Alarplasty

Alarplasty involves the repositioning and strengthening of the alar base – the area around the nostril opening at the bottom of the nose.

During Alarplasty, the opening of the nostrils can be reshaped, repositioned, and strengthened to prevent the lateral walls of the nose from falling inwards, keeping the airways open.

Benefits of Alarplasty as a Nasal Valve Collapse surgery include:

Precisely addressing the affected area of the nose
Addressing functional and aesthetic concerns of the lower nose, without impacting the appearance of other areas
Shorter recovery time compared with other Rhinoplasty procedures

Alarplasty can be an effective treatment option for patients who are affected by mild External Nasal Valve Collapse, with visible signs of the lateral wall pulling inwards. However, it may not be suitable to treat more significant Nasal Valve Collapse concerns, which require a more comprehensive procedure.

Revision Rhinoplasty

In cases where a previous nose surgery has caused Nasal Valve Collapse, a Revision Rhinoplasty may be required to correct the complication. Although Nasal Valve Collapse caused by prior surgery tends to be mild, some people may find that it has a more significant impact on breathing and quality of life.

Revision Rhinoplasty is a bespoke treatment depending on the complications that have arisen from a patient’s specific procedure, and their concerns.

Benefits of Revision Rhinoplasty as a Nasal Valve Collapse surgery include:

Concerns arising from previous Rhinoplasty surgery, which may have been performed for a variety of reasons, can be permanently resolved
Internal and external structures of the nose can be addressed in one procedure
Interim therapies such as Breathing Strips aren’t required

Revision Rhinoplasty has fewer use cases than other types of Nasal Valve Collapse surgery, however for patients who have concerns following a previous procedure, it is a highly valuable option.

Words From Our Founder

Mr. Bryan Mayou

Nasal Valve Collapse is a common cause of breathing difficulties and sleep disorders, which may result in discomfort and affect quality of life in many ways. Although non-surgical treatments can alleviate mild symptoms, Nasal Valve Collapse surgery performed by an expert ENT surgeon may be required to achieve a permanent and comprehensive solution.

Mr. Bryan Mayou

Frequently Asked Questions

What does Nasal Valve Collapse look like?

Nasal Valve Collapse isn’t always obviously visible, depending on the severity of the concern and which valve is affected. Internal Nasal Valve Collapse, which affects the nasal valve anatomy within the mid-section of the nose, is usually invisible and more likely to present with symptoms such as a blocked nose. However, when the external nasal valve boundaries are affected, it may be possible to see the outer walls of the nose pulling in (or collapsing) during inhalation.

The external walls of the nose pulling inwards may not be a definite sign of Anterior Nasal Valve Collapse as a standalone symptom. However, if it has been occurring for an extended period, and other collapsed nasal valve symptoms are present, it is important to have this investigated further.

How does Nasal Valve Collapse happen?

The main reason Nasal Valve Collapse happens is because the cartilage, which makes up the outer (lateral) walls of the nose becomes weakened, causing it to fall inwards during inhalation, narrowing the airway and reducing airflow.

There are several risk factors which can increase the risk of Nasal Valve Collapse occurring:

Deviated septum
Injury
Genetics
Previous nose surgery
Ageing

Your surgeon will discuss the potential causes of Nasal Valve Collapse which may be relevant to you during your personal concerns.

Is Nasal Valve Collapse dangerous?

In many cases, Nasal Valve Collapse isn’t inherently dangerous. Most people experience mild to moderate symptoms, which may not be detectable or noticeably impact breathing or sleep quality.

However, for patients whose collapsed nasal valve symptoms are causing significant concerns, such as a reduction in comfort and quality of life, seeking diagnosis and treatment may be crucial to improve respiratory and wider health.

Does Nasal Valve Collapse get worse?

Depending on the Nasal Valve Collapse causes affecting you, your condition may get worse if the cartilage weakens further. However, for most patients, collapsed nasal valve symptoms remain stable and do not worsen if the integrity of the cartilage doesn’t change.

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