There are many times after trauma to the nose or after rhinoplasty procedures when the nasal cartilage framework loses support. When the loss of cartilage support occurs in the lower lateral cartilage, then the external nasal valve does not have adequate support on nasal inspiration. When the patient inspires forcefully or rapidly, the lower lateral cartilage collapses toward the septum and obstructs the nasal airway. The external valve can be a significant factor in airway obstruction in the previously traumatized or operated nose. The same cartilage weakness can occur when skin cancers, such as basal cell or squamous cell cancers are excised from this segment of the nose.
Restoring the airway in this portion of the nose requires the addition of support to the lower lateral cartilage. This can involve placing a piece of cartilage to support the lower lateral cartilage or replace the entire lower lateral cartilage completely. Cartilage grafts that are effective to reconstruct the lower lateral cartilage can be borrowed from the nasal septal cartilage, ear cartilage, or rib cartilage.