Nasal valve angle or nasal valve groove: Which is more suitable to describe a normal anatomic structure?

The size of the nasal valve angle is often used to assess nasal ventilation. A larger angle of the nasal valve is believed to be more conducive for ventilation, and a small angle is considered unfavorable. However, in more than 30 years of clinical practice, we have experienced that some patients with a normal nasal valve angle have relatively severe subjective or objective nasal ventilation obstruction. By studying the computed tomography data of these patients, we found that the tips of their nasal valves were at a sharp angle, while those of healthy individuals were in an arc shape. A sharp angle at the tip of the nasal valve, therefore, is a risk factor for obstructed nasal ventilation. Herein, we propose that the term “nasal valve groove” may be a more appropriate descriptor for the normal internal nasal valve anatomy, and we hope that more rhinoplasty surgeons will pay attention to how the shape of the tip affects nasal ventilation.