Nasal Hyperventilation With Nasal Valve Collapse!

Can Nasal Congestion and Airflow Acceleration Occur at the Same Time?

Following septorhinoplasty surgery performed abroad, the patient experienced a collapse in the right nasal wing, particularly during inspiration, and a concurrent sensation of cold, dry air. Upon examination, the patient was found to have stenosis in the right nasal valve region (the collapse was evident during inspiration, and the Cottle Maneuver test was positive). The patient underwent right inferior turbinate outfracture and turbinate reduction with radiofrequency at the same clinic. The patient reported that her symptoms improved when she performed the cylinder cotton test with the nasal flap opening device and the tape or device simultaneously. While nasal congestion resolved with the tape or device opening the nasal valve alone, she reported an increased sensation of cold, dry air inside the nose, and impaired sleep quality. Endoscopic examination revealed lateralization and decreased volume of the right inferior turbinate, a greater than normal distance between the turbinate and septum, and dry mucosa, particularly in the right nasal cavity. Endoscopic examination of the patient's left nasal cavity was normal. The patient was scheduled to undergo the following procedures:

• Right Submucosal Costal Cartilage Implantation (Inferior Meatus Augmentation Procedure (IMAP)),
• Open Technique Nasal Valve Surgery
• Right Inferior Turbinate Medialization

The image above was recorded during an endoscopic nasal examination. Following the Right Submucosal Costal Cartilage Implantation (Inferior Meatus Augmentation Procedure (IMAP)), the right inferior meatus was narrowed and augmented. Purple suture material at the incision site is indicated by green arrows. The right inferior turbinate was medialized, and the right ansal airway was narrowed (yellow arrow). However, since the internal silicone splint remained in the nose for 1 week, an ellipsoidal compression area is observed due to the pressure effect.

In the two images above, it is shown with a red arrow that there was a collapse in the right nasal valve area before the operation and that the collapse in this area was eliminated after the operation.

The image above shows cartilage grafts prepared with cartilage obtained from the rib.

Search results link for articles on nasal valve collapse prepared by Dr. Murat Enöz and published on this website (you can also access previous articles by clicking "more posts" at the bottom of the page) >> https://www.ent-istanbul.com/2018/03/nasal-valve-collapse-treatment.html 

Search results link for articles on nasal hyperventilation prepared by Dr. Murat Enöz and published on this website (you can also access previous articles by clicking "more posts" at the bottom of the page) >> https://www.ent-istanbul.com/search?q=nasal+hyperventilation

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon

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