May Newsletter 2024

ALLERGIES AND RHINOPLASTIES

DR. MARK BEATY

Rhinoplasty is a surgery that is designed to improve the appearance, and often the function, of the nose by changing the shape of its external framework. It is common for some of these maneuvers to change the shape of the nasal airway and/or improve support at the internal and external valves. Patients with allergies have swelling of the nasal airway when their allergies are active. These episodes of swelling and inflammation further restrict an already compromised airway. Whenever rhinoplasty maneuvers that improve the nasal airway are performed, there is an opportunity to improve breathing in situations in which the nose would swell, such as with allergies. Allergies are an inflammatory response mediated by the immune system. Surgical changes to the nose do not make any difference in the reactive response of the nose. However, improvement of the nasal airway can be an achievable goal during a

rhinoplasty procedure. Opportunities for improvement include straightening a crooked nasal septum, removing any spurs or irregularities, reducing the size of overly large inferior turbinates, and increasing the stability of the external nasal framework. When the nasal airway is enlarged and/or strengthened, the impact of allergic flare ups is significantly reduced. Nasal valve collapse is the most common cause of airway restriction directly impacted by rhinoplasty. The internal nasal valve is the area where the nasal septum, lateral nasal wall, inferior turbinate and upper lateral cartilage outline the nasal airway. Restriction may occur by deformity, enlargement, or malposition of any of these structures. Fixed structures, such as the septum and inferior turbinates, may be reshaped or modified to reduce restriction of the airway while flexible structures, like the upper lateral cartilage, can be spaced more widely to open the airway. The external nasal valve is the area supported by the columella and lower lateral cartilages, both of which can be supported or repositioned to open and strengthen the airway.

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