title: Functional tension nose as a cause of nasal airway obstruction.
abstract: OBJECTIVE
  The purpose of this prospective study was to evaluate the influence of functional tension nose in nasal obstruction and to discuss its frequency and management.
  
  
  METHODS
  Over the years 2000-2006, 153 patients underwent revision operation for nasal obstruction in our rhinoplastic center. Twenty-two of them (14.37%) suffered from functional tension nose. All 22 patients refused rhinoplasty during primary septoplasty. Sixteen of them had a kyphotic nose and the rest six cases suffered from hanging columella (drooped nose). Eighteen of them underwent primary rhinoplasty in combination with caudal diminution under general anesthesia. The other four patients refused rhinoplasty, and under local anesthesia their tip was deprojected and reprojected.
  
  
  RESULTS
  Marked improvement in nasal airflow was noted at the most recent follow-up evaluation in 20 patients out of 22 (90.91%). The mean length of follow-up was 8 months (ranging from 4 to 12 months). All follow-up results were based on office examination and pre- and post-operative computer-assisted rhinomanometry evaluation. In only two cases results were not efficient enough.
  
  
  CONCLUSIONS
  Our study strongly suggests that tension nose is a usual misdiagnosed cause of nasal obstruction. This problem is concealed under a "kyphotic", "big", or "pinocchio" nose. Usually the functional defect is spontaneously corrected during conventional rhinoplasty. However, tip should be deprojected and reprojected in cases where the patient refuses cosmetic intervention and surgeon tries to resolve his functional problem.
authors: ENT Department of G. Genimmatas General Hospital, Thessaloniki, Greece. ikantas@hol.gr
authors: Ilias V
authors: IV
authors: Kantas
authors: Chariton E
authors: CE
authors: Papadakis
authors: Dimitrios G
authors: DG
authors: Balatsouras
authors: Marinos
authors: M
authors: Vafiadis
authors: Stavros G
authors: SG
authors: Korres
authors: Aggeliki
authors: A
authors: Panagiotakopoulou
authors: Vassilios
authors: V
authors: Danielidis
mesh_terms: D000328:Adult; D000403:Airway Resistance / Q000502:physiology; D005500:Follow-Up Studies; D006801:Humans; D001239:Inhalation / Q000502:physiology; D015508:Nasal Obstruction / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D009300:Nasal Septum / Q000601:surgery; D009666:Nose / Q000002:abnormalities*; D012086:Reoperation; D025363:Rhinomanometry