Prevalence and causes of nasal valve dysfunction in patients with nasal obstruction

In 95% of cases, nasal valve dysfunction (NVD) is the cause of persistent nasal obstruction after septoplasty. However, the analysis of literature shows that there is a small number of publications on the prevalence of NVD and the role of this pathology in the development of nasal breathing disorders is still underestimated. The insufficient information and lack of awareness in physicians on this issue lead to failures in the surgical treatment of patients with nasal obstruction (NO). Objective. To study the prevalence and structure of dysfunction of both nasal valves as well as the role of this pathology in the development of NO. Patients and methods. An analysis of 4440 medical records of patients with complaints of nasal breathing difficulties from 2015 to 2024, who were treated at the otorhinolaryngology department of the Central Clinical Hospital of Civil Aviation, was carried out. Among them, 131 patients with NVD were identified and anatomical causes of NO were studied. Patients underwent: standard examination of ENT organs, examination of the external nose, including without instruments in the lower axial projection, Cottle test, modified Cottle test, photo and video documentation. Results and conclusion. The frequency of narrowing in the internal and external nasal valve amounted to 2.95%. Dysfunction of the external nasal valve was revealed in 69.5% of patients, dysfunction of the internal nasal valve — in 51.1% of patients, and dysfunction of both valves — in 39.8%. In cases of external nasal valve dysfunction, deformation of the lateral crus of the alar cartilage (52.8%), hypertrophy of the soft tissues of the columella (40.7%) and subluxation of the quadrangular cartilage of the nasal septum (40.7%) were more common. In cases of internal nasal valve dysfunction, instability of the upper lateral cartilages (26.8%) and rhinoscoliosis (86.5%) were the predominant issues.