Functional Rhinoplasty/ Nasal Valve Repair

It is becoming increasingly clear that the nasal airway, especially the nostril and septum play a critical role in overall health, especially in sleep breathing disorders like sleep apnea. Not only are we conducting research to improve these procedures as described elsewhere on this site, but we are attempting to understand the cause of the link between nasal valve or nostril problems and sleep disorders.

Nasal valve problems can present as nasal congestion, headache, fatigue and dry mouth, however many end up with a diagnosis of migraines, chronic fatigue or fibromyalgia, and sinusitus or a slew of other symptoms that require expensive treatments and trips to many specialists like neurologists, ENT’s and rheumatologists. Many, in my experience become frustrated with the lack of improvement from the treatments which are sometimes exotic.

Rhinoplasty and Sleep Apnea

In many cases, the sleep apnea is due to two causes. The earliest cause is septal deviation and nostril collapse seen in petit noses or poorly structured noses. This requires people to become mouth breathers during sleep and exercise. Mouth breathing causes tongue collapse during sleep, dry mouth, and the collapse causes headaches and fatigue from reduced brain oxygenation during sleep. The treatment is specialized nasal valve repair and / or CPAP (continuous positive airway pressure). The other cause of mouth-breathing is weight gain, loss of tone, and elevated BMI (body mass index) that affects the chin, neck and chest and causes to mouth to drop or spring open at night, permitting the tongue to collapse into the airway.

This is exacerbated by advancing age which relaxes some of the supportive tissues of the face, neck and chin, causing facial aging, and decreased muscle tone, and worsening of the mouth opening and tongue collapse at night. As mentioned above, this mouth-breathing causes headache, nasal obstruction, loss of energy and fatigue, symptoms that are usually ascribed to other conditions. Conventional medicine tends to split these conditions into other diagnosis and specialties, and sleep apnea masquerades literally as a whole host of other entities like migraine and chronic fatigue syndrome.

A Rhinoplasty Solution

Why does a facial plastic surgeon like me care about this? Two reasons. Many of the people who have these conditions can be helped with a functional rhinoplasty and weight loss, but don’t realize it! Also, chronic sleep apnea and mouth breathing causes reversible aging face changes that can be treated as well, but are better managed by treating the underlying cause of sleep apnea!

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