R J Schlosser1, S S Park. 1. Department of Otolaryngology-Head and Neck Surgery, University of Virginia Medical Center, Charlottesville, USA.
Abstract
OBJECTIVES: To quantify changes in the cross-sectional area of the nasal valve after placement of spreader grafts and flaring sutures and to review clinical outcomes after nasal valve surgery. DESIGN: The minimal cross-sectional area of cadaveric nasal valves was measured after placement of spreader grafts and flaring sutures. Clinical outcomes for patients undergoing functional rhinoplasty were retrospectively reviewed. SETTING: Academic medical center. SUBJECTS: Six fresh cadaver heads and a review of patients from September 1994 through May 1998. INTERVENTION: Acoustic rhinometry was performed after placement of spreader grafts, flaring sutures, and the two together. Clinically, a site-specific repair was performed with spreader grafts and flaring sutures for statically narrowed internal nasal valves and cartilaginous battens for dynamic collapse. MAIN OUTCOME MEASURE: Cross-sectional areas of cadaveric valves. Functional and aesthetic results were determined by nasal patency scores from 1 (complete obstruction) to 10 (complete patency) and a rating of postsurgical cosmetic changes. RESULTS: Spreader grafts improved the cadaveric minimal cross-sectional areas by 5.4% (P > .05), flaring sutures by 9.1% (P > .05), and spreader grafts combined with flaring sutures by 18.7% (P < .05). Mean nasal patency scores improved from 3.4 to 6.5 (P < .01) with the combination of spreader grafts and flaring sutures. Cartilaginous battens improved scores from 2.7 to 6.3 (P < .01). CONCLUSIONS: The combination of flaring sutures and spreader grafts has the greatest impact on the cadaveric nasal airway. Either technique alone failed to have a statistically significant impact on the minimal cross-sectional area of the nasal valve. Clinical review confirms significant improvement in nasal function using this combination technique.
OBJECTIVES: To quantify changes in the cross-sectional area of the nasal valve after placement of spreader grafts and flaring sutures and to review clinical outcomes after nasal valve surgery. DESIGN: The minimal cross-sectional area of cadaveric nasal valves was measured after placement of spreader grafts and flaring sutures. Clinical outcomes for patients undergoing functional rhinoplasty were retrospectively reviewed. SETTING: Academic medical center. SUBJECTS: Six fresh cadaver heads and a review of patients from September 1994 through May 1998. INTERVENTION: Acoustic rhinometry was performed after placement of spreader grafts, flaring sutures, and the two together. Clinically, a site-specific repair was performed with spreader grafts and flaring sutures for statically narrowed internal nasal valves and cartilaginous battens for dynamic collapse. MAIN OUTCOME MEASURE: Cross-sectional areas of cadaveric valves. Functional and aesthetic results were determined by nasal patency scores from 1 (complete obstruction) to 10 (complete patency) and a rating of postsurgical cosmetic changes. RESULTS: Spreader grafts improved the cadaveric minimal cross-sectional areas by 5.4% (P > .05), flaring sutures by 9.1% (P > .05), and spreader grafts combined with flaring sutures by 18.7% (P < .05). Mean nasal patency scores improved from 3.4 to 6.5 (P < .01) with the combination of spreader grafts and flaring sutures. Cartilaginous battens improved scores from 2.7 to 6.3 (P < .01). CONCLUSIONS: The combination of flaring sutures and spreader grafts has the greatest impact on the cadaveric nasal airway. Either technique alone failed to have a statistically significant impact on the minimal cross-sectional area of the nasal valve. Clinical review confirms significant improvement in nasal function using this combination technique.
Authors: Scott Shadfar; William W Shockley; Gita M Fleischman; Anand R Dugar; Kibwei A McKinney; Dennis O Frank-Ito; Julia S Kimbell Journal: JAMA Facial Plast Surg Date: 2014 Sep-Oct Impact factor: 4.611
Authors: Bryan M Brandon; Grace K Austin; Gita Fleischman; Saikat Basu; Julia S Kimbell; William W Shockley; J Madison Clark Journal: JAMA Facial Plast Surg Date: 2018-05-01 Impact factor: 4.611