Vestibuloplasty (a new one-stage operation for atrophic rhinitis).

It is proposed that primary atrophic rhinitis belongs to a group of conditions under the heading 'Reflex Sympathetic Distrophy Syndrome'. This leads to decalcification of the turbinals, as in Sudeck's atrophy. Collapse of the decalcified turbinals is brought about by the impact of the inspiratory stream, and this is followed by atrophic changes. Based on this hypothesis, a new operation ('Vestibuloplasty') has been devised in order to direct the stream away from the turbinals and to dissipate the force of the stream so that its impact on the turbinals is minimized. Following this operation, 92 per cent of the cases have benefitted; this is comparable to the result following Young's or a modified Young's operation. After vestibuloplasty the patient can breathe through the nose and clean the nose as normal persons do; a second-stage procedure for reopening the nostril is not necessary and the chances of recurrence are negligible as compared to those following Young's operation.