Inspiratory nasal obstruction.

Inspiratory nasal obstruction or collapsing alae is caused by a sucking in of the candal cartilaginous parts of the nose; this is followed by a partial or complete stoppage of the inspiratory air. The nose usually assumes a pinched appearance together with a widening of the nostrils during the inspiratory phase, in cases where the collapse is confined to the upper laterals. Weakening of the upper laterals can results from development anomalies, or atrophy of the tissue with aging. Fractures of the nasal framework may cause displacement or buckling, with subsequent thickening or scar formation. This will again result in poor function. In other cases both the upper and lower lateral cartilages become involved with a resulting collapse of the lobule, producing a silit-like appearance of the nostrils. Examination of patients with inspiratory nasal obstruction will often reveal poor support of the upper laterals, deformity of the lower nasal cartilage, columella and nasal spine or dislocation of the candal parts of the septal cartilage, all of which cause obstruction to the inspiratory air. Collapsing alae should be treated by nasal reconstruction, with removal of the obstruction and stabilization of the nasal framework. In children, it has been possible to enhance symmetric growth, and at times, increase growth-potentials by re-alignment of the cartilaginous structures of the nose.