Written by: Joel Hoffman, M.D.
One of the most common issues presented to an Ear, Nose and Throat physician is nasal airway obstruction (stuffy nose). Although a stuffy nose can always be an annoyance, it tends to be worse for many people during exercising and sleeping.
The differential diagnosis for nasal airway obstruction includes a deviated septum (crooked cartilage and bone dividing the nasal passages), a growth in the nasal cavity or behind the nose, enlarged inferior turbinates (swollen structures on the inside of the nose that enlarge with allergy or a common cold) and a nasal valve obstruction. Overall, correcting a deviated septum and reducing the size of the inferior turbinates works approximately 90% of the time. The 10% failure rate is usually secondary to nasal valve problems.
The nasal valve is located between the nasal septum and the sidewall of the nose, and movement occurs as a dynamic process when the air is inspired naturally. However, when the nasal valve is narrowed (less than 10 degrees), patients constantly complain of a stuffy nose.
The traditional manner to correct a narrowed nasal valve requires extensive surgery with a low success rate (50%). Cartilage is harvested from either the septum or ear and placed as a spreader graft in an attempt to widen the nasal valve. However, this technique is no longer performed at North Atlanta ENT & Allergy, as it usually requires an incision under the nose, causing extensive swelling, and often does not work.
Today, there are three other viable options to correct nasal valve obstruction – nasal valve suspension suture, Latera implant insertion and VIVAER.
- Nasal valve obstruction
Dr. Hoffman has been performing nasal valve suspension suture for over 15 years with an excellent success rate of over 90%. The suspension suture provides an advantage over other techniques, in that the valve is actively pulled open, which is important in more difficult cases. Nasal valve suspension is Dr. Hoffman’s “go to” procedure for nasal issues.
Two newer innovative techniques are available for nasal valve surgery as well.
With this procedure, a small absorbable implant is placed along the sidewall of the nose supporting the soft tissue, which helps prevent collapse during inspiration. Latera is a great option for less severe cases, with minimal swelling and a quick recovery. The Latera implant is often performed at the time of a Septoplasty and Inferior turbinate surgery. Over time, the Latera implant becomes incorporated into the soft tissue, creating a support for the sidewall of the nose, and the implant eventually completely resorbs. Dr. Hoffman at NAETNA has performed over 100 Latera implants with positive results.
VIVEAR is a brand new office-based procedure now available for nasal valve obstruction, which is a non-invasive nasal valve remodeling technique. VIVAER uses a small handpiece in the office to reshape the nose tissue in the nasal valve region to improve airflow, without any incisions. Clinical studies have shown that 92% of patients notice an improvement in breathing after VIVAER. Recovery is extremely easy, with minimal pain and no swelling.
North Atlanta ENT & Audiology is unique in offering all of these options to correct nasal valve obstruction. To make an appointment, please contact our office at 770-292-3045, or click here.