Internal nasal valve: revisited with objective facts.

OBJECTIVES: Comprehensive examination of the internal nasal valve (INV) using objective methods.

STUDY DESIGN AND SETTING: In this prospective study, 248 nasal cavities were examined by nasal endoscopy, acoustic rhinometry (ARM), and rhinomanometry (RMM).

RESULTS: Endoscopic examination allowed to suggest a novel classification of INV: convex, concave, sharp angle, blunt angle, twisted caudal border, and angle occupied by the septal body. The INV angle occupied with septal body type was found to have increased nasal resistances compared with the sharp-angled internal nasal valve type (P < 0.05). Convex, concave, and sharp-angle types of INV angles were found different (P < 0.01).

CONCLUSIONS: INV should be examined objectively before any INV surgery. A novel description of the INV configurations and their effects on nasal respiration found in this study may increase our understanding and lead surgical approaches more adequately. A surgical attempt to augment INV angle value may impact positively on nasal resistance.

EBM RATING: C-4.