External Nasal Valve Repair in Children: Alar Batten Graft Reinforced by External Temporary Suspensory Suture

2018 ◽  
Vol 127 (9) ◽  
pp. 598-603
Author(s):  
Ahmed Ibrahim Elsayed ◽  
Yasser Ahmed Fouad ◽  
Ashraf El Malt ◽  
Ahmed Hassan Sweed
Keyword(s):  
Complete Healing ◽  
Nasal Airway ◽  
Nasal Valve ◽  
Symptom Evaluation ◽  
The Mean ◽  
Nasal Valve Collapse ◽  
External Nasal Valve ◽  
Suspension Suture ◽  
Objective Improvement ◽  
Valve Area

Background: The nasal valve area is the narrowest point in the nasal airway. External nasal valve (ENV) collapse during inspiration occurs if external valve area is too narrow or its lateral component is too floppy. Patients and Method: Twelve patients (7 males, 5 females) aged 8 to 12 years complaining of nasal obstruction due to ENV dysfunction underwent surgical intervention using alar batten graft assisted by temporary external suspensory suture. Results: All patients showed subjective and objective improvement of the nasal airway. The mean Nasal Obstructive Symptom Evaluation (NOSE) was 14 ± 1.71 before surgery and 7.83 ± 1.47 1 year after surgery (significant improvement, p ≤ .0001). The mean Peak Inspiratory Flow Rate was 29.92 ± 4.46 before surgery and 42.58 ± 4.93 1 year after surgery (significant improvement, P ≤ .0001). Conclusion: External nasal valve collapse in children can be managed surgically by using alar batten graft. Temporary suspension suture can be helpful for supporting of the graft until complete healing occurs.

Evaluation of a new procedure for nasal alar rim and valve collapse: Nasal alar rim reconstruction

2000 ◽  
Vol 122 (2) ◽  
pp. 204-211 ◽  
Author(s):  
Robert J. Troell ◽  
Nelson B. Powell ◽  
Robert W. Riley ◽  
Kasey K. Li
Keyword(s):  
Retrospective Study ◽  
Medical Center ◽  
Subjective Evaluation ◽  
Alar Cartilage ◽  
Cartilage Graft ◽  
Nasal Valve ◽  
The Mean ◽  
Nasal Valve Collapse ◽  
Alar Rim ◽  
Valve Area

OBJECTIVE A new operative technique to improve nasal valve collapse by placement of cartilage struts along the alar rim was compared with the standard nasal valve cartilage graft (NVG) technique. METHODS AND PATIENTS A retrospective study of consecutive patients with nasal valve collapse was performed at Stanford University Medical Center. Seventy-nine patients with nasal valve collapse underwent reconstruction with either the classic NVG technique or a newly developed nasal alar rim reconstructive (NARR) procedure. The mean age of the NARR group was 50.13 years (SD ± 9.40), with 36 men (92.3%) and 3 women (7.7%). The mean age of the NVG group was 52.14 years (SD ± 10.83), with 36 men (90%) and 4 women (10%). MAIN OUTCOME MEASURES These included functional and subjective evaluation of nasal valve collapse. RESULTS Forty patients (50.6%) underwent the NVG technique, and 39 (49.4%) received the NARR procedure. The NVG technique revealed 0% worsened, 15.0% (6/40) unchanged, 25.0% (10/40) improved, and 60% (24/40) free of obstruction. The NARR procedure revealed 2.6% worsened, 2.6% unchanged, 7.7% improved, and 87.1% free of obstruction. CONCLUSIONS Nasal alar cartilage struts placed along the caudal alar rim offers sufficient support to the alar rim and valve area. This procedure appears to be as effective as currently available reconstructive alternatives, while being technically uncomplicated.

scholarly journals Absorbable Implant to Treat Nasal Valve Collapse

2017 ◽  
Vol 33 (02) ◽  
pp. 233-240 ◽  
Author(s):  
Marion Nicoló ◽  
Klaus Stelter ◽  
Haneen Sadick ◽  
Murat Bas ◽  
Alexander Berghaus
Keyword(s):  
Lateral Cartilage ◽  
Nasal Valve ◽  
Cosmetic Appearance ◽  
Acid Copolymer ◽  
Symptom Evaluation ◽  
Absorbable Implant ◽  
The Mean ◽  
Nasal Valve Collapse ◽  
Operating Suite

Objective To evaluate the safety and effectiveness of an absorbable implant for lateral cartilage support in subjects with nasal valve collapse (NVC) with 12 months follow-up. Methods Thirty subjects with Nasal Obstruction Symptom Evaluation (NOSE) score ≥ 55 and isolated NVC were treated; 14 cases were performed in an operating suite under general anesthesia and 16 cases were performed in a clinic-based setting under local anesthesia. The implant, a polylactic acid copolymer, was placed with a delivery tool within the nasal wall to provide lateral cartilage support. Subjects were followed up through 12 months postprocedure. Results Fifty-six implants were placed in 30 subjects. The mean preoperative NOSE score was 76.7 ± 14.8, with a range of 55 to 100. At 12 months, the mean score was 35.2 ± 29.2, reflecting an average within-patient reduction of –40.9 ± 31.2 points. The majority (76%) of the subjects were responders defined as having at least one NOSE class improvement or a NOSE score reduction of at least 20%. There were no adverse changes in cosmetic appearance at 12 months postprocedure. Three implants in three subjects required retrieval within 30 days postprocedure and resulted in no clinical sequelae. Conclusion This study demonstrates safety and effectiveness of an absorbable implant for lateral cartilage support in subjects with NVC at 12 months postprocedure.

Inspiratory and Fixed Nasal Valve Collapse: Clinical and Rhinometric Assessment

2005 ◽  
Vol 19 (4) ◽  
pp. 370-374 ◽  
Author(s):  
Ramakrishnan Vidyasagar ◽  
Michael Friedman ◽  
Hani Ibrahim ◽  
Darius Bliznikas ◽  
Ninos J. Joseph
Keyword(s):  
Inferior Turbinate ◽  
Nasal Valve ◽  
Dual Mode ◽  
Cross Sectional ◽  
Turbinate Hypertrophy ◽  
Number Of Patients ◽  
Inferior Turbinate Hypertrophy ◽  
Nasal Valve Collapse ◽  
External Nasal Valve ◽  
Valve Area

Background Acoustic rhinometry (AR) has been used to assess nasal valve obstruction. Standard AR measurement of the cross-sectional area (CSA) of the nasal valve is done in the apneic phase, whereas collapse often occurs on inspiration. We used the ratio of the CSA obtained during active inspiration and during apnea to compute a more meaningful method of diagnosing nasal valve collapse. Methods AR was performed in 40 patients without nasal valve obstruction and 47 patients diagnosed with nasal valve obstruction. Patients with septal deflection or anterior inferior turbinate hypertrophy were excluded. The internal and external nasal valve area was observed during apnea and on active inspiration. AR measurement of the CSA of both nasal valves was performed during the apneic phase and during active inspiration and the CSA (inspiratory)/CSA (apneic) ratio was calculated. Results The CSA (inspiratory)/CSA (apneic) ratio was ≥1 in normal patients and in patients with fixed nasal valve collapse. The ratio was <1 in patients with inspiratory collapse. Data from history, physical examination, and dual-mode AR testing successfully differentiated patients into (1) normal valves, (2) fixed valve collapse, and (3) inspiratory valve collapse. A large number of patients with collapse had both internal and external valve obstruction and a large number also had a combination of inspiratory and fixed collapse. Conclusion Dual-mode AR testing is an effective tool in more precisely identifying nasal valve obstruction and is the first objective test shown to be highly diagnostic of inspiratory nasal valve collapse.

scholarly journals Functional and aesthetic outcomes of spreader graft and auto-spreader flap after nasal hump removal

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Maged Baher Naguib ◽  
Mohamed Rifaat Ahmed ◽  
Yasser Taha Madian ◽  
Tarek Mohamady Elnahriry ◽  
Wael Elshahat Eldeeb
Keyword(s):  
Nasal Obstruction ◽  
Operative Time ◽  
Nasal Valve ◽  
Spreader Graft ◽  
Spreader Flap ◽  
The Mean ◽  
The Difference ◽  
A New Technique ◽  
Nasal Valve Collapse ◽  
Duration Of Operation

Abstract Background Following the reduction of the nasal hump to a desired level, spreader grafts are usually positioned to prevent the complication of nasal valve collapse. Auto-spreader flap is a new technique that gained more popularity recently and can be used as an alternative to spreader graft. This RCCT compared between both techniques aesthetically and functionally as well as the operative time. Results Forty patients, 17 males (42.5%) and 23 females (57.5%), were included. The mean duration of operation in auto-spreader flap was 11.8 ± 3.4 min, while it was 19.2 ± 3.2 min in spreader graft. The difference between the two procedures was statistically significant (P < 0.05). Functional assessment of nasal obstruction was done for all patients in both groups preoperative that was (75.6 ± 19.9) which showed marked improvement when re-evaluated 3 moths postoperatively (18.9 ± 14.7), and after 6 months NOSE scale was (29.1 ± 20.2). The overall aesthetic satisfaction was 62.5% (25 of 40) irrespective of the surgery done. Sixteen out of 20 patients in spreader group and 9 out of 20 in auto-spreader flap group. Conclusion Auto-spreader flap and spreader graft are very effective surgical procedure for treatment of nasal obstruction due to internal nasal valve dysfunction, but the auto-spreader flap had shorter operative time. However, spreader graft has a superior aesthetic outcome.

Posttraumatic Nasal Valve Collapse: Is Alar Batten Graft the Answer?

2016 ◽  
Vol 9 (3) ◽  
pp. 125-129
Author(s):  
Avinash Das
Keyword(s):  
Nasal Obstruction ◽  
Visual Analog Scale ◽  
Nasal Valve ◽  
Analog Scale ◽  
Interventional Study ◽  
Symptom Evaluation ◽  
Vas Scores ◽  
Nasal Valve Collapse

ABSTRACT Introduction Posttraumatic nasal valve collapse (NVC) is an underdiagnosed cause of nasal obstruction causing significant symptoms and has been treated by various techniques, the results of which have been variable. In our study, alar batten graft (ABG) has been used to strengthen the nasal wall. Techniques A prospective interventional study was done on 13 patients of posttraumatic NVC using an ABG to reinforce the ala, and results were measured on the basis of standardized nasal obstruction symptom evaluation (NOSE) and nasal obstruction visual analog scale (NO-VAS) scores at 6 months. Results There was a statistically significant improvement in 12 out of 13 patients, with mean improvement of 25.62 on NOSE and 2.4 on NO-VAS scores. There was a visible improvement in the extent of collapse also. Conclusion Posttraumatic NVC can be treated effectively using ABG, with significant improvement in standard scores as well as the symptomatology. How to cite this article Maggon NV, Sethi A, Das A. Posttraumatic Nasal Valve Collapse: Is Alar Batten Graft the Answer? Clin Rhinol An Int J 2016;9(3):125-129.

scholarly journals Lateral Crural Insertion Graft for External Nasal Valve Collapse

2020 ◽  
Vol 22 (2) ◽  
pp. 110-111
Author(s):  
Dominic Vernon ◽  
Andrew Lee ◽  
Ira Papel
Keyword(s):  
Nasal Valve ◽  
Nasal Valve Collapse ◽  
External Nasal Valve
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