Nasal valve obstruction: a comprehensive analysis of the current literature and proposal of a management algorithm

Nasal valve obstruction (NVO) remains challenging to diagnose and treat. This review explores the persisting controversies of NVO management, emphasising the lack of consensus in diagnostic criteria and treatment protocols among otolaryngologists and facial plastic surgeons. Recent surveys highlight...

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Main Authors: Francesca Pirola, Raymond Kim, Richard Douglas
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Surgery
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2025.1549915/full
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author Francesca Pirola
Raymond Kim
Richard Douglas
author_facet Francesca Pirola
Raymond Kim
Richard Douglas
author_sort Francesca Pirola
collection DOAJ
description Nasal valve obstruction (NVO) remains challenging to diagnose and treat. This review explores the persisting controversies of NVO management, emphasising the lack of consensus in diagnostic criteria and treatment protocols among otolaryngologists and facial plastic surgeons. Recent surveys highlight the central dilemma: for many patients who have both septal deviation and NVO, a septoplasty alone provides adequate symptomatic improvement. However, some with this combination of problems continue to be troubled by nasal obstruction if only a septoplasty is performed. This underscores the critical question of when NVO necessitates specific surgical intervention. The varying diagnostic approaches that have been used and the limited outcome data currently available conspire to make this question difficult to answer with certainty. This review will also address the role of the inferior turbinates in NVO management, proposing their inclusion in NVO surgical planning. Other techniques will also be discussed for their potential impact on nasal valve dynamics. Both endonasal and open approaches to correcting the caudal septum need to be considered when discussing NVO repair. A treatment algorithm for NVO will be presented as a practical guide for the management of this condition.
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spelling doaj-art-03c44faba302483fa6f7a9a1fe1f5ab22025-08-20T01:49:36ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-03-011210.3389/fsurg.2025.15499151549915Nasal valve obstruction: a comprehensive analysis of the current literature and proposal of a management algorithmFrancesca Pirola0Raymond Kim1Richard Douglas2ORL Department, Auckland City Hospital, Auckland, New ZealandDepartment of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New ZealandDepartment of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New ZealandNasal valve obstruction (NVO) remains challenging to diagnose and treat. This review explores the persisting controversies of NVO management, emphasising the lack of consensus in diagnostic criteria and treatment protocols among otolaryngologists and facial plastic surgeons. Recent surveys highlight the central dilemma: for many patients who have both septal deviation and NVO, a septoplasty alone provides adequate symptomatic improvement. However, some with this combination of problems continue to be troubled by nasal obstruction if only a septoplasty is performed. This underscores the critical question of when NVO necessitates specific surgical intervention. The varying diagnostic approaches that have been used and the limited outcome data currently available conspire to make this question difficult to answer with certainty. This review will also address the role of the inferior turbinates in NVO management, proposing their inclusion in NVO surgical planning. Other techniques will also be discussed for their potential impact on nasal valve dynamics. Both endonasal and open approaches to correcting the caudal septum need to be considered when discussing NVO repair. A treatment algorithm for NVO will be presented as a practical guide for the management of this condition.https://www.frontiersin.org/articles/10.3389/fsurg.2025.1549915/fullnasal valvevalve collapsenasal obstructionnasal obstruction measurementnasal valve repair
spellingShingle Francesca Pirola
Raymond Kim
Richard Douglas
Nasal valve obstruction: a comprehensive analysis of the current literature and proposal of a management algorithm
Frontiers in Surgery
nasal valve
valve collapse
nasal obstruction
nasal obstruction measurement
nasal valve repair
title Nasal valve obstruction: a comprehensive analysis of the current literature and proposal of a management algorithm
title_full Nasal valve obstruction: a comprehensive analysis of the current literature and proposal of a management algorithm
title_fullStr Nasal valve obstruction: a comprehensive analysis of the current literature and proposal of a management algorithm
title_full_unstemmed Nasal valve obstruction: a comprehensive analysis of the current literature and proposal of a management algorithm
title_short Nasal valve obstruction: a comprehensive analysis of the current literature and proposal of a management algorithm
title_sort nasal valve obstruction a comprehensive analysis of the current literature and proposal of a management algorithm
topic nasal valve
valve collapse
nasal obstruction
nasal obstruction measurement
nasal valve repair
url https://www.frontiersin.org/articles/10.3389/fsurg.2025.1549915/full
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AT raymondkim nasalvalveobstructionacomprehensiveanalysisofthecurrentliteratureandproposalofamanagementalgorithm
AT richarddouglas nasalvalveobstructionacomprehensiveanalysisofthecurrentliteratureandproposalofamanagementalgorithm