title: Endonasal spreader graft placement as treatment for internal nasal valve insufficiency: no need to divide the upper lateral cartilages from the septum.
abstract: OBJECTIVE
  To describe and evaluate results of a surgical procedure to treat internal nasal valve insufficiency with the use of spreader grafts placed via an endonasal approach without division of the upper lateral cartilages from the nasal septum.
  
  
  METHODS
  Eighty-nine patients with complaints of nasal obstruction, at least partially due to internal nasal valve insufficiency, underwent this operation on 120 sides in a private practice setting. Only autologous material was used, and 3 different techniques for fixating the grafts were evaluated. All patients were prospectively studied, and subjective self-assessment was used to quantify the result of the operation.
  
  
  RESULTS
  On 53 sides (44%) nasal breathing was described as "optimal," and on 53 sides (44%) the result was deemed "improved." On 13 sides (11%) no change was noted, and on 1 side (1%) the postoperative situation was judged to be worse.
  
  
  CONCLUSIONS
  When opting for spreader grafts to treat internal nasal valve insufficiency, one does not necessarily need to perform an external approach, nor is separation of the upper lateral cartilages from the septum required. The endonasal technique presented herein is less invasive and can be used in conjunction with other procedures aimed at improving nasal patency.
authors.affiliation: Department of Otolaryngology and Facial Plastic Surgery, Gooi Noord Hospital, Blaricum, The Netherlands. r.andre@planet.nl
authors.forename: Robert F
authors.initials: RF
authors.lastname: André
authors.forename: Santdeep H
authors.initials: SH
authors.lastname: Paun
authors.forename: Hadé D
authors.initials: HD
authors.lastname: Vuyk
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000002:abnormalities* / Q000601:surgery*; D012225:Rhinoplasty / Q000379:methods*; D016378:Tissue Transplantation