Abstract

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.