title: Functional rhinoplasty with batten and spreader grafts for correction of internal nasal valve incompetence.
abstract: OBJECTIVE
  We a describe technique for correction of internal nasal valve incompetence (INVI) using functional rhinoplasty (FRP) with combined cartilaginous batten and spreader grafts and report the functional and cosmetic outcomes.
  
  
  METHODS
  Prospective series using subjective improvement in nasal airway and quality of life.
  
  
  METHODS
  Subregional ENT centre, one operating rhinologist.
  
  
  METHODS
  Twenty-three consecutive adults presenting to ENT department at North Hertfordshire NHS Trust with symptomatic INVI.
  
  
  METHODS
  Pre and post-operative symptom scores for nasal obstruction and its impact on overall quality of life using visual analogue scales (1-100mm). Cosmetic outcome graded using subjective scores. Statistical analysis performed using the Wilcoxon signed rank test.
  
  
  RESULTS
  We found a median subjective improvement on the visual analogue scale of 55 mm for nasal patency (p<0.001) and of 49 mm for quality of life (p<0.001). Twenty-two patients felt that the appearance of their nose had not changed or had significantly improved post operatively.
  
  
  CONCLUSIONS
  Combined use of batten and spreader grafts for the correction of INVI in normal or narrow nasal vaults is effective without compromising cosmesis.
authors.affiliation: Department of Otorhinolaryngology, Lister hospital, Stevenage, Hertfordshire, United Kingdom.
authors.forename: C
authors.initials: C
authors.lastname: Faris
authors.forename: E
authors.initials: E
authors.lastname: Koury
authors.forename: P
authors.initials: P
authors.lastname: Kothari
authors.forename: A
authors.initials: A
authors.lastname: Frosh
mesh_terms: D002356:Cartilage / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D015508:Nasal Obstruction / Q000209:etiology / Q000601:surgery*; D009668:Nose Diseases / Q000150:complications / Q000601:surgery*; D011446:Prospective Studies; D012225:Rhinoplasty / Q000379:methods*