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| After completion hand this to your rhinoplasty specialist |
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.
*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
- 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 [18].
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 [5].
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 [16].
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