Understanding the nasal airway: principles and practice

LEARNING OBJECTIVES: After studying this article, the reader should be able to: 1. Describe the soft-tissue, cartilaginous, and bony anatomy of the nose. 2. Describe the anatomy and function of the nasal valves. 3. Discuss the governing physiologic principles responsible for airflow dynamics. 4. Discuss the various functions of the nose. 5. Demonstrate an appropriate evaluation of the nasal airway. 6. Discuss the differential diagnosis of nasal obstruction. 7. Discuss appropriate management options for nasal airway obstruction.The nose is a complex, multifunctional organ that requires respect and understanding from the rhinoplasty surgeon. The etiologic and pathologic characteristics of each patient's nasal airway problem determine the treatment of the nasal airway. Frequently, medical management is sufficient without operative intervention. Recent advances have shown that nasal valves in airway patency may play a more important role than the septum. The rhinoplasty surgeon's understanding of the anatomy and physiology of the nasal airway, along with the causes of obstruction, can pave the way for a proper evaluation and appropriate management of nasal airway problems. Lack of understanding can result in misdiagnosis and mismanagement. This article outlines current concepts of medical and surgical management of nasal airway problems and discusses in detail the key concepts and principles in the practical management of the nasal airway.