Nasal reconstruction with conchal cartilage. Correcting valve and lateral nasal collapse.

OBJECTIVE: To analyze the causes and the subsequent management of a collapsed valve and lateral nasal wall. The causes, including both predisposing anatomy and the surgical contributions, are presented.

DESIGN: Analysis of consecutive patients with lateral nasal wall collapse corrected surgically with autogenous conchal cartilage grafts.

PATIENTS: Fifty-six patients (37 women and 19 men; age range, 19 to 71 years) with nasal wall collapse were operated on. Forty-one of these patients had undergone at least one previous nasal procedure. The collapse of the nasal wall as a result of senescence was repaired in 13 patients. Two instances of nasal collapse were thought to be due to trauma. Forty-five patients had bilateral involvement.

RESULTS: All 56 patients showed subjective improvement in nasal airway breathing. Rhinomanometry was performed in 24 patients and documented the improvement in all 24. Fifty-three patients noted an improvement in the appearance of their noses. Minimal morbidity was noted and no major complications were seen. Follow-up ranged from 18 months to 13 years.

CONCLUSION: Surgery is very beneficial in cases of severe nasal collapse. This major functional complication warrants this major surgical reconstructive procedure and, as the results of this study demonstrate, predictable positive results with little morbidity and no major complications are possible.