Bending of the upper lateral cartilages for nasal valve collapse.
BACKGROUND
As a consequence of removal of the nasal hump, the upper lateral cartilages are separated from the septal cartilage in reductive rhinoplasty. A decrease in the nasal airway cross-sectional area and collapse of the internal nasal valve (INV) are inevitable unless additional surgical measures are taken.


OBJECTIVE
To determine the efficacy of the horizontal mattress bending suture in treating patients with nasal valve collapse.


METHODS
Each upper lateral cartilage was separately bent to a certain degree with a horizontal mattress suture following nasal dorsum reduction in the external septorhinoplasty as a preventive or corrective measure for the INV stenosis. The efficacy of this suture was assessed in 28 patients who presented with tension nose by comparing the INV angles preoperatively and 12 months postoperatively, as determined photographically by means of a rigid nasal endoscope.


RESULTS
The mean +/- SD preoperative INV angle was calculated as 9.1 degrees +/- 4.2 degrees (range, 0 degrees -18.3 degrees ). The mean postoperative INV angle was increased to 25.3 degrees +/- 3.8 degrees (range, 18.4 degrees -34.5 degrees ) (P<.001).


CONCLUSIONS
This method reconstitutes the normal anatomy of the INV, reestablishes stiffness or resistance of the nasal side walls so that they do not bend inwardly with inspiration, improves the airflow at this area, and avoids postoperative nasal valve stenosis in functional-cosmetic rhinoplasty cases that require considerable nasal hump reduction.
Ozturan
Orhan
O
Faculty of Medicine, Department of Otorhinolaryngology, Inonu University, Malatya, 44300 Turkey. orhanent@yahoo.com
Miman
Murat Cem
MC
Kizilay
Ahmet
A
D000293:Adolescent; D000328:Adult; D002356:Cartilage / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D015508:Nasal Obstruction / Q000209:etiology; D009300:Nasal Septum / Q000473:pathology / Q000601:surgery; D012086:Reoperation; D012225:Rhinoplasty / Q000009:adverse effects / Q000379:methods*; D013536:Suture Techniques