In some, tip repositioning may produce better breathing results, and a ptotic tip might be the culprit, he said. The greatest challenge occurs when a valve dysfunction is suspected but the patient also has a deviated septum. In these cases, the physician will have to make the difficult decision about what is really the cause.
“I think this is where the finesse comes in,” Dr. Spiegel said. “You really have to make your best judgment.”
Getting good results is often possible, but not without careful attention to diagnosis, said Stephen Park, MD, vice chair of otolaryngology-head and neck surgery at the University of Virginia in Charlottesville.