Effects of rhinoplasty on the internal nasal valve: a comparison between internal continuous and external perforating osteotomy.

The purpose of the study was to compare the effect of 2 widely used methods of lateral osteotomy on the internal nasal valve (INV) by measuring minimal cross-sectional area using acoustic rhinometry (AR) and computed tomography (CT) in the pre- and postoperative setting. Thirty adult patients noting nasal deformity requiring rhinoplasty were enrolled. Patients were divided into 3 groups of 10 patients. Patients in group 1 had bilateral lateral osteotomies by the internal continuous technique. In group 2, lateral osteotomies were performed by the external perforating technique. In group 3, osteotomies were performed by the external perforating technique on the left side and by the internal continuous technique on the right side in the same patient. Each patient had their INVs measured pre- and postoperatively at 6 weeks using AR and CT of the nasal bones. Lateral osteotomy decreases the INV (measured by both AR and CT scan) (P < 0.009). There was no statistically significant difference between the 2 types of osteotomies with respect to the degree of narrowing on the INV (CT-derived P = 0.24 and AR-derived P = 0.60). When comparing AR and CT data regarding the INV, we observed a measurable decrease in the nasal airway after lateral osteotomy in all patients. There was no statistically significant difference to conclude that either internal continuous osteotomy or external perforating osteotomy caused more narrowing of the nasal airway.