February 16, 2015
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Rhinoplasty has little effect on airway, resistance for external nasal valve dysfunction

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For patients with external nasal valve dysfunction, surgical intervention did not change structural shape or resistance during normal breathing; however, researchers found symptoms improved with changes in collapsibility.

In a prospective case series, researchers observed 19 patients with external nasal valve dysfunction (ENVD) and nasal obstruction who underwent functional reconstructive rhinoplasty involving lateral crural underlay strut grafts using either cartilage or lateral crural cephalic turn-in maneuvers.

The objective assessment included nasal peak inspiratory flow, nasal airway resistance and minimum cross-sectional area, whereas subjective assessment included a visual analog scale for nasal obstruction, the 22-item Sinonasal Outcome Test, the Nasal Obstruction symptom Evaluation Scale and the 36-item Short Form Health Survey, version 2. The researchers also used a 13-point Likert scale to assess overall function and cosmesis.

Postoperatively, significant improvements were observed for the Sinonasal Outcome test, Nasal Obstruction Symptom Evaluation scale, and overall function and cosmesis change, according to the researchers. However, no significant changes were observed for median nasal airway resistance or the minimum cross-sectional area.

The researchers observed significant improvement in patient-related outcome measures following rhinoplasty to correct ENVD. However, although general quality of life improved postoperatively, no significant changes were observed.

According to the researchers, a relationship between nasal airway resistance and minimum cross-sectional area may exist, where the shape of the minimum cross-sectional area may be just as important as the minimum cross-sectional area value because the shape has consequences for both airflow and nasal airway resistance.

The researchers concluded that although rhinoplasty may improve function and cosmesis among patients with ENVD, as measure by improvements in subjective results, not all breathing constructs demonstrated objectively measureable changes. – by Abigail Sutton

Disclosures: Palesy reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.