A 25-year-old athlete complains of nasal obstruction during exercise. On examination, there is collapse of the nasal sidewall during inspiration. Cottle's test improves airflow. The internal nasal valve angle is measured at less than 10 degrees. What is the anatomical cause?
- A Narrowing of the internal nasal valve angle between the upper lateral cartilage and nasal septum ✓
- B Weak lower lateral cartilages
- C Hypertrophy of the inferior turbinate
- D Anterior septal deviation
Correct answer: A. Narrowing of the internal nasal valve angle between the upper lateral cartilage and nasal septum
Explanation
Nasal valve collapse occurs when the internal nasal valve angle (normally 10-15 degrees between the upper lateral cartilage and septum) is narrowed, causing inspiratory collapse of the nasal sidewall. Cottle's test (lateralizing the cheek) improves airflow by stabilizing the valve. This is distinct from external valve collapse (weak lower lateral cartilages) and turbinate hypertrophy. Treatment involves spreader grafts or batten grafts to support the valve.
Reference: Cummings Otolaryngology, 7th ed.
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Written and medically reviewed by the StethoPrep medical team.