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COLLAPSED ALA: Pathologic Physiology and Management

COLLAPSED ALA: Pathologic Physiology and Management Abstract THE PURPOSE of this paper is to discuss a type of inspiratory nasal obstruction in which the lateral cartilaginous wall is sucked against the septum, partially or completely shutting off the onward passage of air. The condition is commonly referred to as "collapsed" or "collapsing" ala. Perhaps the term "cartilaginous inspiratory obstruction" would better represent the syndrome. The clinical picture is characteristic (fig. 1). If the collapse involves both upper and lower lateral cartilages, or only the latter, the entire cartilaginous walls collapse and the nostrils appear slitlike with each inspiration. If the collapse is limited to the upper lateral cartilages, the central portion of the nose assumes a pinched appearance, the nostrils dilate markedly and the exaggerated activity of the alar muscles is clearly visible. In either case the degree of collapse is in direct proportion to the depth of the inspiratory effort. Occasionally, the closure is so abrupt References 1. von Mihalkovics, V.: Anatomy and Embryology of the Nose and Its Sinuses , in Heymann, P.: Handbuch der Laryngologie und Rhinologie , Vienna, A. Hölder, 1900, vol. 3, (pt. 1) . 2. Fenn, W. O.: Mechanics of Contraction , in Bethe, A; Bergmann, G.; Embden, G., and Ellinger, A.: Handbuch der normalen und pathologischen Physiologie mit Berücksichtigung der experimentellen Pharmakologie , Berlin, Julius Springer, vol. 8, (pt. 1) , 1928. 3. Fenn, W. O., Isotonic Contractions in Muscle , Symp. Quant. Biol. 4:233, 1936.Crossref 4. Drury, D.: Personal communication to Dr. Victor Goodhill. 5. Rohrer, R.: Current Resistance in the Human Respiratory Passages and the Effect of the Irregular Ramification of the Bronchial System on the Course of the Air in the Various Pulmonary Regions , Arch. f. d. ges. Physiol. 162:225, 1915.Crossref 6. Uddströmer, M.: Nasal Respiration: A Critical Survey of Some Current Physiological and Clinical Aspects on the Respiratory Mechanism with a Description of a New Method of Diagnosis , Acta oto-laryng. , 1940, (supp. 42) , p. 3 7. The Importance of the Conchae for the Resistance Within the Normal Nose , Uddströmer Acta oto-laryng. (supp. 42) 28:364, 1940.Crossref 8. van Dishoeck, H. A. E.: Electrogram of the Alar Muscles and Nasal Resistance Curve , Acta oto-laryng. 25:285, 1937.Crossref 9. Carpenter, T. M., and Lee, R. C.: Influence of Glucose and of Fructose on Effective Dead Space in Human Respiration , Am. J. Physiol. 104:10, 1933. 10. Mink, P. J.: Physiologie der oberen Luftwege , Leipzig, F. C. W. Vogel, 1920. 11. Negus, V. E.: The Mechanism of the Larynx , St. Louis, C. V. Mosby Company, 1929. 12. Proetz, A. W.: Essays on the Applied Physiology of the Nose , St. Louis, Annals Pub. Co., 1941. 13. Traube: Report , Berl. klin. Wchnschr. 25:293, 1871. 14. Feldbausch: A New Method of Permanent Inhalation of Volatile Substances Through the Nose , Berl. klin. Wchnschr. 17:672, 1880. 15. Jankau, cited by Weihl, A.: Insuction of the Alae , Ztschr. f. Laryngol. u. Rhinol. 9:30, 1919-1920. 16. Guye, cited by Weihl, A.: Insuction of the Alae , Ztschr. f. Laryngol. u. Rhinol. 9:30, 1919-1920. 17. Ott, cited by Weihl, A.: Insuction of the Alae , Ztschr. f. Laryngol. u. Rhinol. 9:30, 1919-1920. 18. Schmidthuisen, cited by Weihl, A.: Insuction of the Alae , Ztschr. f. Laryngol. u. Rhinol. 9:30, 1919-1920. 19. Heermann, G.: A Simple Method of Preventing Insuction of the Alae , Ztschr. f. Ohrenh. 56:165, 1908. 20. Menzel, K. M.: The Treatment of Alar Insuction: A New Method , München. med. Wchnschr. 50:778, 1903. 21. Fomon, S.: The Surgery of Injury and Plastic Repair , Baltimore, Williams & Wilkins Company, 1939. 22. Fomon, S.; Syracuse, V. R.; Bolotow, N., and Pullen, E. M.: Plastic Repair of the Deflected Nasal Septum , Arch. Otolaryng. 44:141 ( (Aug.) ) 1946.Crossref 23. Fomon, S.; Gilbert, J. G.; Silver, A. G., and Syracuse, V. R.: Plastic Repair of the Obstructing Nasal Septum , Arch. Otolaryng. 47:7 ( (Jan.) ) 1948.Crossref 24. Schattner, A.: Personal communication to the authors. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology American Medical Association

COLLAPSED ALA: Pathologic Physiology and Management

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References (22)

Publisher
American Medical Association
Copyright
Copyright © 1950 American Medical Association. All Rights Reserved.
ISSN
0003-9977
DOI
10.1001/archotol.1950.00700020488001
Publisher site
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Abstract

Abstract THE PURPOSE of this paper is to discuss a type of inspiratory nasal obstruction in which the lateral cartilaginous wall is sucked against the septum, partially or completely shutting off the onward passage of air. The condition is commonly referred to as "collapsed" or "collapsing" ala. Perhaps the term "cartilaginous inspiratory obstruction" would better represent the syndrome. The clinical picture is characteristic (fig. 1). If the collapse involves both upper and lower lateral cartilages, or only the latter, the entire cartilaginous walls collapse and the nostrils appear slitlike with each inspiration. If the collapse is limited to the upper lateral cartilages, the central portion of the nose assumes a pinched appearance, the nostrils dilate markedly and the exaggerated activity of the alar muscles is clearly visible. In either case the degree of collapse is in direct proportion to the depth of the inspiratory effort. Occasionally, the closure is so abrupt References 1. von Mihalkovics, V.: Anatomy and Embryology of the Nose and Its Sinuses , in Heymann, P.: Handbuch der Laryngologie und Rhinologie , Vienna, A. Hölder, 1900, vol. 3, (pt. 1) . 2. Fenn, W. O.: Mechanics of Contraction , in Bethe, A; Bergmann, G.; Embden, G., and Ellinger, A.: Handbuch der normalen und pathologischen Physiologie mit Berücksichtigung der experimentellen Pharmakologie , Berlin, Julius Springer, vol. 8, (pt. 1) , 1928. 3. Fenn, W. O., Isotonic Contractions in Muscle , Symp. Quant. Biol. 4:233, 1936.Crossref 4. Drury, D.: Personal communication to Dr. Victor Goodhill. 5. Rohrer, R.: Current Resistance in the Human Respiratory Passages and the Effect of the Irregular Ramification of the Bronchial System on the Course of the Air in the Various Pulmonary Regions , Arch. f. d. ges. Physiol. 162:225, 1915.Crossref 6. Uddströmer, M.: Nasal Respiration: A Critical Survey of Some Current Physiological and Clinical Aspects on the Respiratory Mechanism with a Description of a New Method of Diagnosis , Acta oto-laryng. , 1940, (supp. 42) , p. 3 7. The Importance of the Conchae for the Resistance Within the Normal Nose , Uddströmer Acta oto-laryng. (supp. 42) 28:364, 1940.Crossref 8. van Dishoeck, H. A. E.: Electrogram of the Alar Muscles and Nasal Resistance Curve , Acta oto-laryng. 25:285, 1937.Crossref 9. Carpenter, T. M., and Lee, R. C.: Influence of Glucose and of Fructose on Effective Dead Space in Human Respiration , Am. J. Physiol. 104:10, 1933. 10. Mink, P. J.: Physiologie der oberen Luftwege , Leipzig, F. C. W. Vogel, 1920. 11. Negus, V. E.: The Mechanism of the Larynx , St. Louis, C. V. Mosby Company, 1929. 12. Proetz, A. W.: Essays on the Applied Physiology of the Nose , St. Louis, Annals Pub. Co., 1941. 13. Traube: Report , Berl. klin. Wchnschr. 25:293, 1871. 14. Feldbausch: A New Method of Permanent Inhalation of Volatile Substances Through the Nose , Berl. klin. Wchnschr. 17:672, 1880. 15. Jankau, cited by Weihl, A.: Insuction of the Alae , Ztschr. f. Laryngol. u. Rhinol. 9:30, 1919-1920. 16. Guye, cited by Weihl, A.: Insuction of the Alae , Ztschr. f. Laryngol. u. Rhinol. 9:30, 1919-1920. 17. Ott, cited by Weihl, A.: Insuction of the Alae , Ztschr. f. Laryngol. u. Rhinol. 9:30, 1919-1920. 18. Schmidthuisen, cited by Weihl, A.: Insuction of the Alae , Ztschr. f. Laryngol. u. Rhinol. 9:30, 1919-1920. 19. Heermann, G.: A Simple Method of Preventing Insuction of the Alae , Ztschr. f. Ohrenh. 56:165, 1908. 20. Menzel, K. M.: The Treatment of Alar Insuction: A New Method , München. med. Wchnschr. 50:778, 1903. 21. Fomon, S.: The Surgery of Injury and Plastic Repair , Baltimore, Williams & Wilkins Company, 1939. 22. Fomon, S.; Syracuse, V. R.; Bolotow, N., and Pullen, E. M.: Plastic Repair of the Deflected Nasal Septum , Arch. Otolaryng. 44:141 ( (Aug.) ) 1946.Crossref 23. Fomon, S.; Gilbert, J. G.; Silver, A. G., and Syracuse, V. R.: Plastic Repair of the Obstructing Nasal Septum , Arch. Otolaryng. 47:7 ( (Jan.) ) 1948.Crossref 24. Schattner, A.: Personal communication to the authors.

Journal

Archives of Otolaryngology – American Medical Association

Published: Apr 1, 1950

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