Nasal airway obstruction is a common clinical problem in the general adult population. Common structural causes of nasal obstruction include septal deviation, turbinate hypertrophy, nasal polyposis, and adenoid hypertrophy. However, another important and often overlooked etiology is nasal valve compromise. 1 Nasal valve compromise is a distinct and primary cause of nasal airway obstruction and can occur in isolation or in combination with other anatomic or inflammatory causes of nasal obstruction. 2 The nasal valve is the region of the nasal cavity with the greatest resistance to airflow. The nasal septum and inferior turbinate are rigid structures within the nose. The dynamic lateral nasal wall can have a significant effect on the nasal valve region and overall nasal airflow. Patients with nasal valve compromise may have a weakened lateral nasal wall, which contributes to the dynamic or static area of airflow restriction within the nose.Diagnosis is based primarily on history and physical examination. The main symptom of nasal valve compromise is decreased nasal airflow, but patients may also report increased nasal obstruction with deep inspiration. Patients may experience symptomatic improvement via manual lateral distraction of the cheek and nose. Physical examination may show weak or malformed nasal cartilages and collapse of the lateral nasal wall or alar rim on inspiration. 2 Strategies to address nasal valve compromise typically seek to increase the overall diameter of the nasal valve region or increase the rigidity of the lateral nasal wall. 3