Lateral augmentation of the middle third of the nose with autologous cartilage in nasal valve insufficiency.
Nasal valve insufficiency (NVI) is a troublesome clinical entity for both the patient and the otorhinolaryngologist. Aetiological factors include congenital and iatrogenic causes, trauma, aging. Pathology is frequently located in the middle third of the nose: the upper lateral cartilages (ULC) and the cartilaginous septum (CS). The nasal valve (NV) is the plane through the caudal edges of the ULC and the CS, and is part of a larger three-dimensional area called the nasal valve area (NVA). The NVA is considered to have the narrowest cross-sectional area of the entire airway. Between 1989-1992, 32 patients with nasal obstruction due to an incompetent nasal valve were surgically treated by lateral augmentation with autologous cartilage "spreader" grafts, placed between the CS and the ULC to widen the apex of the NVA. In all cases the open approach for rhinoplasty (OSR) was used. After a mean follow-up of 18 months, 27 patients were evaluated by a self-administered questionnaire, head-and-neck examination, nasal endoscopy, photography and video-documentation of the NVA. The patient's subjective opinion was used in the assessment of the surgical success. In 48% of the patients there was complete resolution of complaints. An overall improvement of nasal patency was seen in 81% of the cases. No major complications occurred. The indications, technique and results are presented.
Department of Otorhinolaryngology/Head and Neck Surgery, De Wever Hospital, Heerlen, The Netherlands.
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D000328:Adult; D002356:Cartilage / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015508:Nasal Obstruction / Q000453:epidemiology / Q000601:surgery*; D009300:Nasal Septum / Q000601:surgery; D017060:Patient Satisfaction; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D013997:Time Factors; D014182:Transplantation, Autologous