The American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) issued a position statement recognizing surgical repair of the nasal valve as a distinct surgical procedure that can improve nasal obstruction symptoms for certain patients with nasal valve collapse.  

According to the position statement, the treatment of nasal valve dysfunction may involve techniques including cartilage grafting and open surgical repair, suture suspension techniques, implants, or radiofrequency treatment aimed at stabilizing the nasal valve.

“Failure to perform nasal valve repair, when indicated, is a common cause of incomplete symptom resolution for patients with nasal obstruction and nasal valve dysfunction,” reads the statement.  

The statement notes that surgical repair of the nasal valve can be performed alone or with other procedures to improve nasal obstruction. Septoplasty, turbinate reduction, endoscopic sinus surgery, and others may be used in conjunction with nasal valve repair, but AAO-HNS says they are not effective substitutes “as they do not address nasal valve dysfunction.”

When feasible, AAO-HNS recommends surgical treatment to address all contributing anatomic sites be performed concomitantly. Requiring septoplasty and/or turbinate surgery before nasal valve surgery is not recommended, as this may lead to unnecessary increases in surgical encounters, according to the position statement.

Furthermore, AAO-HNS emphasizes that nasal valve dysfunction is a structural issue that cannot be effectively addressed with medical treatments such as intranasal steroids and that conservative therapies like nasal cones or external nasal dilator adhesive strips are not viable long-term solutions.

The statement recommends office-based techniques, including implants and radiofrequency treatment, to stabilize the nasal valve, while surgical treatment, along with treatment of other possible causes of nasal airway obstruction, is recommended for patients requiring anatomic widening and definitive stabilization of the nasal valve. 

“We thank the AAO-HNS leadership for its advocacy on behalf of otolaryngologists in identifying and treating nasal valve collapse to optimize patient outcomes,” says Matt Brokaw, CEO of Aerin Medical, makers of a radiofrequency-based device that repairs nasal valve prolapse, in a release. “Nasal airway obstruction is one of the primary reasons a patient visits an ENT physician, and we hope that this enables ENTs to treat nasal valve collapse with minimally invasive solutions when it contributes to nasal obstruction.”

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