The nasal valve: a physiological and clinical study.

Fifteen subjects underwent nasal pressure gradient studies to determine the resistance profile of the nose. Seventy-nine per cent of nasal resistance to airflow occurred in the segment 0 cm.-2.8 cm. from the posterior margin of the anterior nares. The greater part of this resistance (43 per cent) occurred in the segment 1.5 cm.-2.8 cm. within the nose, and this area approximated to the site of the pyriform aperture. Eighteen patients underwent a trial of radical trimming of the inferior turbinates (12 patients) versus anterior trimming of the inferior turbinates (6 patients). Both operations produced a similar fall in nasal resistance to airflow, confirming that the region of the pyriform aperture was the site of maximum nasal resistance. Whereas the radical operation significantly reduced the sensation of nasal obstruction, the anterior operation did not. The results of the study are discussed with reference to previous work on the subject.