Association of inferior turbinate enlargement, concha bullosa and nasal valve collapse with the convexity of septal deviation

2010 ◽  
Vol 130 (2) ◽  
pp. 271-274 ◽  
Author(s):  
Ahmet Ural ◽  
Alper Kanmaz ◽  
Hasan Mete İnançli ◽  
Mehmet İmamoğlu
Keyword(s):  
Inferior Turbinate ◽  
Septal Deviation ◽  
Concha Bullosa ◽  
Nasal Valve ◽  
Nasal Valve Collapse

scholarly journals Bioabsorbable Implant for Treatment of Nasal Valve Collapse with or without Concomitant Procedures

2021 ◽  
Author(s):  
Douglas M. Sidle ◽  
Pablo Stolovitzky ◽  
Ellen M. O'Malley ◽  
Randall A. Ow ◽  
Nathan E. Nachlas ◽  
...  
Keyword(s):  
Adverse Events ◽  
Nasal Obstruction ◽  
Large Population ◽  
Inferior Turbinate ◽  
Nasal Valve ◽  
Serious Adverse Events ◽  
Vas Scores ◽  
Nasal Implant ◽  
Nasal Valve Collapse

AbstractThe aim of the study is to report outcomes after treatment of nasal valve collapse with a bioabsorbable nasal implant. It involves two prospective, multicenter, post-market studies evaluating long-term effectiveness of the LATERA implant for severe to extreme nasal obstruction. Participants underwent implant alone or with concomitant inferior turbinate reduction (ITR) and/or septoplasty. Outcome measures included the change from baseline Nasal Obstruction Symptom Evaluation (NOSE) scores, NOSE responder rates, visual analog scale (VAS) scores, and adverse events. A total cohort of 277 participants (109 implants only, 67 implants + ITR, 101 implants + septoplasty + ITR) enrolled at 19 U.S. centers was available for analysis with 177 participants (69 implants only, 39 implants + ITR, 69 implants + septoplasty + ITR) available at 2 years. The mean changes from baseline in NOSE scores and VAS scores were statistically significant (p < 0.001) at all follow-up periods. The baseline NOSE score of 77.8 ± 13.6 was improved to 24.2 ± 23.6 at 24 months. Greater than 90% of participants were NOSE responders across all follow-up periods, 6.1% withdrew for lack of treatment effect. The baseline VAS score of 66.7 ± 18.8 was improved to 21.1 ± 23.9 at 24 months. There were no serious adverse events related to the device or implant procedure. Implant retrieval rate was 4.0% (22/543 implants). Nonserious adverse events were mild to moderate in severity, typically occurred within 6 months of implant, and resolved or were stable. Significant reductions in NOSE and VAS scores and high responder rates from our large population of patients with nasal obstruction who had nasal valve implants confirm sustained effectiveness at 24 months after treatment. The studies are registered on www.clinicaltrials.gov (NCT02952313 and NCT02964312).

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 Diagnosis and management of septal deviation and nasal valve collapse - a survey of Canadian otolaryngologists

2019 ◽  
Vol 48 (1) ◽  
Author(s):  
Yiqiao Wang ◽  
James P. Bonaparte
Keyword(s):  
Variable Number ◽  
Septal Deviation ◽  
Diagnostic Methods ◽  
Diagnostic Tools ◽  
Nasal Valve ◽  
Diagnosis And Management ◽  
Important Concern ◽  
Facial Plastic ◽  
Examination Methods ◽  
Nasal Valve Collapse

Abstract Background Management of nasal valve collapse (NVC) in patients with a septal deviation can be challenging. Our objective was to determine the opinions of Canadian Otolaryngologists regarding the diagnosis and management of nasal obstruction in patients with septal deviation and NVC. Methods A twenty-question survey was developed for the purpose of our study. Questions were divided into the following areas: diagnosis, management and prognosis. We included all otolaryngologists who were members of the Canadian Society of Otolaryngology. Results The response rate to our survey was 18%. The most commonly identified cause of a failed septoplasty was incomplete septoplasty (41.9%), followed by nasal valve collapse (25.6%). The Cottle manoeuvre (62.8%) and visual inspection (39.5%) were noted to be the most important diagnostic tools for external and internal NVC respectively. However, physicians often rely on a variable number of different examinations when making a diagnosis of nasal valve collapse. When evaluating which patients with a septal deviation also required nasal valve surgery, 27.9% of responders believed the current physical examination methods provided a high accuracy, while 55.8% indicated moderate accuracy and 16.3% indicated low accuracy. Compared to other subspecialties in Otolaryngology, Facial Plastic and Reconstruction Surgeons noted higher septoplasty failure rates in patients with co-morbid NVC. Conclusions NVC is an important concern for otolaryngologists performing septoplasty. Although most physicians believe that the physical exam provides a moderate effectiveness when predicting who requires a functional rhinoplasty, diagnostic methods used for NVC is varied and inconsistent.

scholarly journals Nasal Airway Obstruction: Prevalence and Anatomic Contributors

2018 ◽  
Vol 97 (6) ◽  
pp. 173-176 ◽  
Author(s):  
David W. Clark ◽  
Anthony G. Del Signore ◽  
Roheen Raithatha ◽  
Brent A. Senior
Keyword(s):  
Airway Obstruction ◽  
Nasal Obstruction ◽  
Inferior Turbinate ◽  
Septal Deviation ◽  
Lateral Nasal Wall ◽  
Nasal Airway ◽  
Turbinate Hypertrophy ◽  
Inferior Turbinate Hypertrophy ◽  
Nasal Valve Collapse ◽  
Surgical Treatments

Surgical treatments for nasal airway obstruction (NAO) are commonly offered as part of otolaryngology practice. Anatomic causes include septal deviation, inferior turbinate hypertrophy, and nasal valve collapse (NVC). This study was performed to determine the prevalence of anatomic contributors to NAO. A total of 1,906 patients with sinonasal complaints were surveyed by 50 otolaryngologists in varying U.S. geographic regions. Patients were first evaluated using the Nasal Obstruction Symptom Evaluation (NOSE) instrument to assess the NAO symptoms and their severity. Physicians then examined patients for the presence of the three anatomic contributors. Presence of septal deviation and turbinate hypertrophy was assessed through an internal nasal exam with direct or endoscopic visualization based on the physician's standard methodology for diagnosis. Presence of NVC was determined by the modified Cottle maneuver. Among all patients surveyed, prevalence was 67% for NVC, 76% for septal deviation, and 72% for inferior turbinate hypertrophy. We found that 64% of the patients (n = 1,211) had severe/extreme NOSE scores (≥55), representing the most likely nasal obstruction candidates for intervention. In these patients, the prevalence of NVC, septal deviation, and inferior turbinate hypertrophy was 73, 80, and 77%, respectively. Eighty-two percent of the 236 patients with severe/extreme NOSE scores who reported prior septoplasty and/or inferior turbinate reduction had NVC. Our study revealed a comparable prevalence of all three anatomic contributors across all patients and the subset with severe/extreme NOSE scores, highlighting the importance of evaluating the lateral nasal wall as a component of NAO treatment strategy.

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.

Relationship between Pediatric Concha Bullosa and Septal Deviation

2014 ◽  
Vol 151 (1_suppl) ◽  
pp. P126-P126
Author(s):  
Amin Amali ◽  
Amir A. Sazgar ◽  
Mohammad Sadeghi ◽  
Babak Saedi ◽  
Maziar M. Langeroudi ◽  
...  
Keyword(s):  
Septal Deviation ◽  
Concha Bullosa

The Effect of Nasoalveolar Molding on Nasal Airway Anatomy

2018 ◽  
Vol 55 (4) ◽  
pp. 596-601 ◽  
Author(s):  
Jonathan P. Massie ◽  
Karl Bruckman ◽  
William J. Rifkin ◽  
Christopher M. Runyan ◽  
Pradip R. Shetye ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Inferior Turbinate ◽  
Septal Deviation ◽  
Nasal Airway ◽  
Retrospective Case ◽  
Tertiary Referral Center ◽  
Nasal Cartilage ◽  
Inferior Turbinate Hypertrophy ◽  
Nasoalveolar Molding ◽  
Control Study

Objective: To determine the effects of nasoalveolar molding (NAM) on nasal airway architecture. Design: Retrospective case-control study of patients with unilateral cleft lip treated with NAM vs without NAM. Setting: Tertiary referral center specializing in cleft and craniofacial care. Patients, Participants, and Interventions: Thirty-six patients with complete unilateral cleft lip and alveolus: 19 with NAM therapy and 17 without NAM therapy. Main Outcome Measures: Cone beam computed tomography (CBCT) scans were compared in multiple coronal sections and were evaluated for linear and angular septal deviation, inferior turbinate hypertrophy, and linear and 2-dimensional airway area. Results: There were no significant differences in linear or angular septal deviation, inferior turbinate area, linear stenosis, or airway area between NAM- and non-NAM-treated patients. Conclusions: NAM effectively molds the external nasal cartilage and structures but may have limited effects on internal nasal structures.

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