Nasal Airflow: Insights from ENT Expert Dr. Cheng - Otolaryngology

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Hello, thank you for your thoughtful questions regarding nasal airflow and related issues. I appreciate your engagement and am happy to provide further insights based on my clinical experience and knowledge in the field of otolaryngology.


Q1: Nasal Aperture Size and Airflow
You are correct in understanding that the size of the nasal passages (or nostrils) is indeed related to the volume of air that can be inhaled. However, it is important to clarify that while a larger nasal aperture can facilitate greater airflow, the presence of nasal congestion or obstruction can significantly impact this relationship. When the nasal passages are clear, airflow is optimized, and the risk of hypoxia (oxygen deficiency) or respiratory distress is minimized. Conversely, if there is nasal congestion—due to conditions such as allergic rhinitis, sinusitis, or structural abnormalities—this can lead to reduced airflow, which may cause symptoms like difficulty breathing through the nose, but not necessarily hypoxia. In essence, while nasal size and airflow are correlated, the primary concern with nasal obstruction is not typically hypoxia but rather the discomfort and complications associated with inadequate nasal breathing.


Q2: Prevalence of External Nasal Valve Collapse
Regarding the prevalence of external nasal valve collapse, it is relatively uncommon in the general population but can be more frequent in individuals with specific anatomical predispositions or those who have experienced trauma to the nose. In my clinical experience, external nasal valve collapse is often seen in patients who have undergone previous nasal surgeries, such as rhinoplasty, or those with congenital deformities. While it is not a widespread issue, it is significant enough that it warrants attention in patients presenting with nasal obstruction or cosmetic concerns.


Q3: Causes of External Nasal Valve Collapse
In addition to congenital factors and trauma, other causes of external nasal valve collapse can include:
1. Aging: As individuals age, the structural integrity of the nasal cartilage can diminish, leading to a loss of support for the nasal valve area. This can result in a more pronounced collapse during inhalation.

2. Chronic Inflammation: Conditions such as chronic rhinosinusitis or prolonged nasal obstruction can lead to changes in the nasal structure over time, contributing to valve collapse.

3. Allergic Rhinitis: Chronic inflammation from allergies can lead to swelling and changes in the nasal tissues, which may affect the structural support of the nasal valve.

4. Environmental Factors: Prolonged exposure to irritants, such as smoke or pollutants, can lead to chronic nasal inflammation and potential structural changes.

5. Nasal Surgery: Previous surgical interventions can inadvertently weaken the support structures of the nose, leading to collapse.

In summary, while external nasal valve collapse is not exceedingly common, it can occur due to a variety of factors, including aging and chronic nasal conditions. It is essential for individuals experiencing nasal obstruction or airflow issues to consult with an ENT specialist for a thorough evaluation and appropriate management.

If you have further questions or need clarification on any specific points, please feel free to ask. Your understanding of these concepts is crucial for managing nasal health effectively. Thank you for your inquiry, and I wish you the best in your health journey.