Treatment of Nasal Obstruction

Journal of Long-Term Effects of Medical Implants, 13(3)259-269 (2003)

Treatment of Nasal Obstruction From Nasal Valve Collapse with Alar Batten Grafts

Daniel G. Becker, MD, FACS¹ & Samuel S. Becker, MD, MFA²

¹Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania
Hospital, Philadelphia, Pennsylvania; ²Department of Otorhinolaryngology-Head and Neck
Surgery, University of Virginia Hospital, Charlottesville, Virginia

Address all correspondence to Dr. Daniel G. Becker, Dept. of Otorhinolaryngology-Head and Neck Surgery, Univ. of Pennsylvania Hospital, 3400 Spruce Street, 7 Silverstein, Philadelphia PA 19104; beckermailbox@aol.com

ABSTRACT: Nasal obstruction may require treatment with rhinoplasty techniques. One cause of nasal obstruction is known as nasal valve colapse. This refers to narrowness and weak­ness at the nasal valve, the narrowest part of the nasal airway. There are a number of surgical approaches available to treat nasal valve collapse. Selection of the appropriate surgical inter­vention depends on proper identification of the anatomic cause of the collapse. Alar batten grafts are especially useful for addressing nasal valve collapse caused by a weak nasal sidewall. In this report, we review the senior author's experience with the use of alar batten grafts for nasal valve collapse.

Twenty-one patients had septoplasty with placement of alar batten grafts; all patients noted improvement in their nasal breathing. Seven patients underwent ear cartilage harvest with alar batten grafts, and five of them noted improvement, one noted partial improvement, one noted no improvement. Six patients underwent revision septorhinoplasty with alar batten grafting, and ten patients underwent revision septorhinoplasty with ear cartilage harvest and alar batten grafting. These patients all reported improvement in their nasal breathing postoperatively. Six patients underwent revision rhinoplasty (no septoplasty) with ear cartilage and battens. These patients hold special interest because no other intranasal procedures were performed that af­fected nasal breathing. All six of these patients reported significant improvement of their nasal breathing and all patients were satisfied with their postsurgical cosmetic appearance.

The nasal valve area is considered to be the location of the least cross-sectional area in the nose. When narrowing of the nasal valve is a result of collapse of the nasal sidewall, alar batten grafts are a useful technique to address the patient's nasal obstruction.

KEYWORDS: nasal valve, nasal obstruction, rhinoplasty, septoplasty

Document ID# JLT1303-259-269(192) 2S9 1050-6934/03 $5.00 © 2003 by Begell House, Inc.

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