Welcome to North Atlanta Ear, Nose and Throat Blog. Our practice has been open for almost one month. We are very excited about our fast growth. As we add members to this blog, we will take request for topics to discuss. Today I will give an overview of an innovative procedure that I have been performing for the past 6-7 years, Nasal valve suspension suture.
Nasal airway obstruction (stuffy nose) is one of the most
common complaints presenting to an Ear, Nose and Throat physician. The differential diagnosis is quite extensive
including deviated septum (crooked cartilage and bone dividing the nasal
passages), a growth in the nasal cavity
or behind the nose, enlarged inferior
turbinate’s (swollen structures on the inside of the nose that enlarge with
allergy or a common cold) and finally nasal valve obstruction. The nasal valve is located between the nasal
septum and the side wall of the nose.
Movement of the nasal valve occurs as a dynamic process when air is
inspired naturally. However, when the
nasal valve is narrowed (less than 10 degrees), patients complain of a stuffy
nose constantly.
The most common surgery performed to correct nasal blockage
is called a septoplasty and turbinate reduction. The surgery is performed as an
outpatient under general anesthesia, takes me less than 45 minutes and requires
no nasal packing. In my practice, demand
for this procedure is very high given the high success rate and the minimal
recovery. Time off work usually is no
more than an extended weekend (3-4 days).
My overall success rate is over 90%.
For the small percentage of patients who do not respond, the problem
usually involves the nasal valve.
The traditional manner to correct a narrowed nasal valve
requires extensive surgery with a low success rate (50%). Cartilage is harvested from either the septum
or ear and placed as a spreader graft in an attempt to widen the nasal valve. I abandoned this technique several years
ago. The procedure usually requires an
incision under the nose causes extensive swelling and often does not work.
I observed an innovative technique to correct nasal valve
narrowing at a surgical course 6-7 years ago and have perfected the procedure
with over 300 cases to date. The surgery
is called a nasal valve suspension suture.
Unlike the spreader graft technique, the suspension suture is simple,
quick and highly effective with a success rate of 90-95 %.
The suspension surgery involves placement of a suture
through a very small incision under the eye hidden in a skin crease. In over 300 cases, the small incision has
universally healed beautifully. The
suture is passed under the skin to the nasal valve and is placed on tension to
suspend the nasal valve in an open position.
The sensation of an open nasal passage with placement of the nasal valve
suture can be simulated by pulling on the side of your cheek in an upward and
outward manner (cottle maneuver). This manually stretches open the valve. The
suture, however, holds the valve in the open position permanently. Placement of the suture does not result in
any change in appearance visible to the eye.
The majority of procedures on the nasal valve are undertaken
for patients who continue to experience nasal blockage after undergoing
septoplasty, however, some patients have the suture placed at the time of the
initial nasal surgery.
If you have a problem with nasal airway obstruction, feel
free to make an appointment for evaluation. With nearly 20 years’ experience in
providing exceptional ENT care to the Cumming area, I strongly feel that I can
correct your problem. It is important to
understand that in many cases, surgery is not
required. In the cases that do
necessitate a surgery, my practice can offer the most advanced and complete
techniques available.
