Endonasal Repositioning of the Upper Lateral Cartilage and the Internal Nasal Valve

AbstractObstruction of the nasal valve is an important cause of chronic nasal obstruction in adults. In a series of 500 patients, obstruction at the level of the nasal valve was diagnosed in 65 of them (13 per cent). The obstruction was unilateral in 57 patients (88 per cent). Forty-seven patients (72 per cent) had history of previous nasal surgery of accidental trauma. Causes of obstruction of the nasal valve included high septal deviations, a weak or deformed upper lateral cartilage, adhesions, and alar collapse. All patients underwent corrective nasal surgery and the surgical procedures were tailored according to the existing pathology. Post-operatively, the mean nasal patency score increased from 2.9 to 8.6, the mean nasal airflow increased from 579.5 to 727 cm/sec (at 150 Pa), and the mean nasal resistance decreased from 0.31 to 0.23 Pa/cm3sec-1.

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Modified autospreader flap for nasal valve support: utilizing the spring effect of the upper lateral cartilage

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-014-3309-7 ◽

2014 ◽

Vol 272 (2) ◽

pp. 497-504 ◽

Cited By ~ 9

Author(s):

Wael Khamis Hussein ◽

Samy Elwany ◽

Motaz Montaser

Keyword(s):

Lateral Cartilage ◽

Nasal Valve ◽

Upper Lateral Cartilage

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Endonasal Triangular Technique for nasal valve rhinoplasty: a ten year review

Otolaryngologia Polska ◽

10.5604/01.3001.0012.4365 ◽

2018 ◽

Vol 72 (5) ◽

pp. 45-50

Author(s):

Ngalufua'atonga Havea ◽

Cheryl Tang ◽

Jason Rockey ◽

Angelica Lynch

Keyword(s):

Nasal Obstruction ◽

Revision Surgery ◽

Lateral Cartilage ◽

Endonasal Approach ◽

Nasal Valve ◽

Upper Lateral Cartilage ◽

Main Regulator ◽

Regional Hospitals ◽

Subjective Reports

Introduction: The nasal valve is the main regulator of airflow in the nose. Consequently, the collapse of the nasal valve has a significant impact on nasal obstruction and hence quality-of-life of patients. Several nasal valve rhinoplasty techniques are being used, from cartilage grafts to endonasal resection of the upper lateral cartilage. We describe a new endonasal approach to nasal valve rhinoplasty, the Triangular Technique, and assess its efficacy and complication rate over ten years. Materials and Methods: A retrospective study of patients who underwent nasal valve rhinoplasty at three regional hospitals from Jan 2004 to May 2014 was conducted. Subjective reports were used to assess the improvement of nasal obstruction. 24 patients were included. Results: 3 months postoperatively, 19 patients reported improvement in nasal obstruction. 4 patients required revision surgery. 2 of these 4 patients had substantial symptom resolution post revision surgery. 10 patients were followed up for more than 5 years (range: 5.8 to 10.3 years), 9 of who reported continued satisfaction and none or minimal nasal obstruction after nasal valve rhinoplasty compared to before surgery. There were no reported complications. Discussion: The Triangular Technique is a straightforward endonasal technique to address collapsed nasal valves with minimal associated co-morbidities.

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The Four Components of the Nasal Valve

American Journal of Rhinology ◽

10.1177/194589240301700208 ◽

2003 ◽

Vol 17 (2) ◽

pp. 107-110 ◽

Cited By ~ 68

Author(s):

Philip Cole

Keyword(s):

Cross Sectional Area ◽

The Body ◽

Isometric Contractions ◽

Lateral Cartilage ◽

Sectional Area ◽

Nasal Valve ◽

Cross Sectional ◽

Airflow Resistance ◽

Orifice Flow ◽

Upper Lateral Cartilage

The nasal valve consists of four distinct airflow-resistive components. (i) The vestibule terminates in an airflow-resistive aperture between the septum and the caudal end of the upper lateral cartilage. Its cross-sectional area is stabilized by the cartilaginous structures and by inspiratory isometric contractions of alar dilator muscles. Its walls are devoid of erectile tissues that might otherwise affect its cross-sectional area and airflow resistance. By contrast, (ii) the bony entrance to the cavum is occupied by erectile tissues of both (iii) lateral (turbinate) and (iv) septal nasal walls that modulate the cross-sectional area of the airway and airflow resistance. The body of the cavum offers little resistance to airflow. Valve constrictions induce “orifice flow” of inspiratory air as it enters the body of the cavum, disrupting laminar characteristics and thereby enhancing exchanges with the nasal mucosa of heat, water, and contaminants. Acoustic rhinometric and rhinomanometric measurements show the sites, dimensions, and resistances of the valve constrictions and indicate that it is seldom necessary to extend septal and/or turbinate surgery far beyond the piriform aperture in the treatment of nasal obstruction.

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Upper Lateral Cartilage Suspension Over Dorsal Grafts: A Treatment for Internal Nasal Valve Dynamic Incompetence

Facial Plastic Surgery ◽

10.1055/s-2008-1064332 ◽

1999 ◽

Vol 15 (04) ◽

pp. 309-316 ◽

Cited By ~ 25

Author(s):

Sebastiano Sciuto ◽

Daniele Bernardeschi

Keyword(s):

Lateral Cartilage ◽

Nasal Valve ◽

Upper Lateral Cartilage

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History of Dorsum Conservative Techniques in Rhinoplasty: The Evolution of a Revived Technique

Facial Plastic Surgery ◽

10.1055/s-0041-1724031 ◽

2021 ◽

Author(s):

Diego Arancibia Tagle ◽

Jose Carlos Neves ◽

Alwyn D'Souza

Keyword(s):

Lateral Cartilage ◽

Classic Problem ◽

Alternative Option ◽

History Of ◽

Upper Lateral Cartilage ◽

The Aesthetic

AbstractThe correction and management of the nasal hump has been a classic problem in rhinoplasty since the beginning of the aesthetic purpose of this surgery. For many years, the resective technique described by Joseph has been the battle horse to solve this problem but it has several drawbacks if not done properly. In the late 19th and early 20th centuries, a new dorsal conservative technique was born and for several years was an alternative option to treat the same problem without damaging the keystone area while preserving the dorsal connection between the upper lateral cartilage and the septum. The aim of this article is to review the history and evolution of this technique, which has been reborn after several years, and how it has evolved since then.

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