A simple and reliable method of patient evaluation in the surgical treatment of nasal obstruction.

We have developed a simple method of evaluating nasal obstruction both before and after corrective surgery. With our system, patients self-rate their nasal patency on a 10-point visual analog scale under different conditions. After a baseline self-assessment, patients rate their breathing while the examiner lifts the lower lateral nasal cartilage with an ear curette and again during lifting of the upper lateral cartilage. Separate assessments during cartilage support are made before and after the patient has received nasal decongestion therapy. The results of these manipulations help identify the specific structural abnormality and its anatomic site, thereby serving as a reliable aid to planning surgery (i.e., open septorhinoplasty, turbinoplasty, external valve surgery with alar batten grafts, and/or internal valve surgery with spreader grafts with or without composite skin/cartilage grafts). We tested our method in preoperative evaluation and surgical planning on 19 patients with nasal obstructions. Our method was just as useful in making postoperative assessments, and it allowed us to judge the effectiveness of specific procedures in restoring nasal patency. Of the 19 patients, 18 (94.7%) reported that their nasal breathing had improved following surgery.