Surgery of the incompetent nasal valve.

One of the causes of nasal airway obstruction during inspiration is an incompetent nasal valve. An incompetent valve is one that collapses during quiet normal breathing due to narrowing of the valve area, a loss of upper and/or lower lateral cartilage support, or a combination of these. The most common etiology is a previous rhinoplasty; trauma and aging are other causes. Treatment is surgical and consists of replacing what is missing with similar tissue. If only the vestibular skin is scarred, a skin graft is used. If cartilage alone is missing, a cartilage graft is inserted. If both skin and cartilage are absent, a composite graft from the concha is the best choice.