By Daniel Larson, MD
Breathe Right® Strips consist of a flexible band of material that sticks to the external skin of the nose which causes the area just above the nostril openings to spring open, thereby increasing airflow. This product is, in fact, treating a condition called nasal valve collapse. The nasal valve is the area of the inner nose that lies between the nostril opening and the nasal bones. Due to the physics of airflow through the nasal passages, this area acts as a choke point for airflow. A small amount of narrowing in this area can lead to very significant nasal congestion, decreased airflow and facial pressure.
For patients with nasal valve collapse, their congestion is usually worsened when they lay down or when they exercise – this is why Breathe Right® Strips are marketed for use mostly at night time and during exercise. In fact, nasal valve collapse is a major cause of CPAP intolerance in patients with obstructive sleep apnea.
It is not always obvious why nasal valve collapse occurs, but often it is due to prior trauma to the nose or may occur with the aging process and cartilage weakening.
Depending on the severity of your symptoms there are many options for treating nasal valve collapse.
For mild nasal valve collapse, nasal stents such as Breathe Right® Strips or MaxAir® Nose cones may be sufficient to treat nighttime or intermittent symptoms. Occasionally, nasal steroid sprays (eg Flonase®) can improve the symptoms of nasal valve collapse by opening other areas of the nasal passages.
For more severe nasal valve collapse that does not respond to medications, the least invasive option would be an in-office procedure to remodel the tissue in this area. An option available at our offices is the Vivaer® device. This device delivers radiofrequency energy through the nasal tissues to reshape the soft tissue and cartilage of the nasal valve. It is also used to reshape the soft tissues of the nasal turbinates and septum. The procedure takes less than 30 minutes to complete in the office with only local anesthesia and requires no cutting or bleeding. A recent study in 50 patients showed an average improvement of 70% in nasal symptoms and high patient satisfaction. Learn more here.
For patients with firm collapse of the nasal valves or severe septal deviations, a surgery such as a septoplasty or functional septorhinoplasty (aka vestibular stenosis repair) may be in order .