ijcmcr International Journal of Clinical & Medical Case Reports 2834-250X International Journal of Clinical & Medical Case Reports Research The ‘W-to-V’ Technique: An Effective Method for Nasal Valve Repair Daoud Amani Department of Otolaryngology, Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel; The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel Dror Amiel Department of Otolaryngology, Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel; The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel Geva Shiri Department of Otolaryngology, Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel Saffoury Insaf Department of Otolaryngology, Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel Jane-Ohayon Tali The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel Sela Eyal Department of Otolaryngology, Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel; The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel 19 12 2025 7 1 22112025 13122025 © 2025 The Author(s). Published by International Journal of Clinical & Medical Case Reports. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0).

Introduction: The internal nasal valve is the narrowest segment of the nasal airway, making nasal valve stenosis (NVS) a major contributor to nasal obstruction. Prior rhinoplasty is a frequent cause of NVS. Although multiple surgical techniques have been described, the quality of supporting evidence remains low, resulting in continued debate about the optimal management strategy. Objective: To describe a novel, “W-to-V” technique for treating NVS and to evaluate postoperative improvement in nasal obstruction symptoms. Methods: A retrospective medical record review identified patients with nasal obstruction due to NVS who underwent the “W-to-V” technique. Participants completed the NOSE and VAS scales preoperatively and at one month postoperatively. The procedure involves creating a “W”-shaped incision along the inter-cartilaginous junction, followed by placement of traction sutures designed to widen and stabilize the internal nasal valve. Detailed operative steps and illustrations are provided. Results: Fifteen patients were included (87% female; mean age 35.5 years). No postoperative complications occurred. Mean NOSE scores improved from 68.8 to 11.2 (p < 0.001), and VAS scores decreased from 6.8 to 1.8 (p < 0.001), demonstrating significant symptomatic improvement. Conclusion: The “W-to-V” technique is a minimally invasive, mucosal-sparing approach that effectively improves nasal obstruction. Larger prospective studies are required.

Nasal Valve Stenosis Rhinoplasty Nasal Obstruction Nasal Reconstruction Revision Rhinoplasty