Tuesday, October 1, 2019

Diagram sheet for future patients to indicate nasal area(s) of collapsing

Here's a free hand drawing i put together of four different nasal views so you could better communicate with your rhinoplasty specialist where you believe you're experiencing nasal valve &/or nostril collapsing.
After completion hand this to your rhinoplasty specialist

*For more preciseness hold or stand in front of a mirror &  try the cottle maneuver &/or cotton swab to lateralize each nostril  if you're not sure where your weak spots are.  While keeping your mouth closed inhale & exhale with only your nose before and during this exercise.  Note differences on each side.  You can also cover up one nostril with your thumb and notice how the other side changes while breathing in & out.

Diagnosing Nasal Valve Collapse

Examination of the nose and any of the following may help in appropriately diagnosing nasal valve collapse:
  • Endoscopy
  • Cottle's maneuver - nasal valve area is widened by pulling it in a lateral direction, may be performed. If breathing improves when the nasal valve area is manually widened, it is an indication of nasal valve collapse.
  • Bachman's maneuver. During this maneuver, the nasal valve is widened using instruments and then improvements in breathing are assessed.
  • Nasal decongestant drops
  • Anterior rhinomanometry - measures nasal airflow
  • Acoustic rhinometry - uses sound waves to assess changes in the nasal cavity. https://www.verywellhealth.com/nasal-valve-collapse-1191944
A more comprehensive analysis
Diagnosing disorders of the nasal valve area
In addition to septal deviations and turbinate hypertrophy, disorders of the nasal valve often result in an obstruction of nasal breathing and are frequently overlooked and/or not covered in a systematic examination for lack of knowledge. This results in false diagnoses and unsuccessful surgical treatments of impaired nasal breathing []. For the evaluation of the nasal respiratory function in the region of the nasal valve area, there is currently no singular examination method that reliably pictures the patient’s symptoms on account of the complex physiological correlations and the multitude of subjective factors []. The knowledge of the physiological correlations and the physician’s clinical experience are essential for making the correct diagnosis and selecting a promising therapy. Therefore, the development of reproducible diagnostic parameters is required for the purposes of evidence-based medicine.

The patient's history is very important in the diagnostic investigation of impairments of nasal breathing. It provides an indication of the presence of pathologies in the region of the nasal valve area and in particular of the subjective estimation of the severity of the symptoms. In this context, possible causes of a disorder of the nasal valve have to be explored as well.

Regarding the ENT findings, it has to be found out whether the inspiratory collapse of the nasal valve is a clinically relevant suction phenomenon or whether other pathologies are present as well. The common distinction between physiological and pathological suction phenomena is not always useful since the extent of suffering that varies from patient to patient is the decisive factor for the performance of any possible therapy. The inspection of the nose should be carried out both using instruments and without instruments. While doing so, the following details have to be paid attention to: size and shape of the isthmus nasi, septal deviation in the region II, nasal valve angles smaller than 15 degrees, deformities of the lateral or alar cartilages, elasticity of the cartilages, breadth of the columella, cicatricial stenoses, size of the body piriform aperture. In case of a positive suction phenomenon, it should be examined which parts of the lateral nasal wall are concerned. To this effect, the caudal edge of the lateral cartilage, the lateral crus of the alar cartilage and the lateral lower skinny-membranous portion of the wing of the nose have to be evaluated [].

Monday, September 3, 2018

Latera: Temporary absorbable nasal implant for nasal valve collapse

In July 2016 Spirox announced it won FDA approval for it's absorbable non invasive Latera implant to help counter nasal valve collapse.

 "A multi-center study of the device, conducted in Germany, demonstrated that patients who received a Latera implant experienced a reduction in nasal obstruction symptoms at 1-year post procedure, without a reported cosmetic downside.

“Nasal obstruction takes a significant toll on patient quality of life, but is often undertreated and underdiagnosed. If we don’t look for nasal valve collapse in these patients, we’re not addressing the entire problem. By providing an intuitive and effective way to support nasal Lateral cartilage, Latera has the potential to improve breathing for our patients,” Dr. Dean Toriumi of Chicago’s University of Illinois said in a press release.

“We have worked with physician leaders to find a solution to a major clinical need. The research and development behind the innovation is complex, but the technique is elegant and intuitive. Latera gives physicians a new option to support Lateral cartilage, enabling a more complete means for addressing their patients’ nasal obstruction symptoms,” CEO Duke Rohlen said in a prepared statement.