title: In-office surgical repair of nasal valve stenosis.
abstract: BACKGROUND
  Nasal valve (NV) stenosis is a well-known cause of nasal obstruction (NO) and congestion but it is often overlooked because the typical surgical therapies are complex and often associated with cosmetic changes. A simplified surgical procedure is needed to address straightforward stenosis of the NV in patients with no need of cosmetic improvement or cartilage grafting. The purpose of this article is to describe a simplified surgical procedure to relieve symptoms of NO without extensive surgical dissection, sedation, cartilage grafting, or cosmetic change.
  
  
  METHODS
  This article describes a retrospective consecutive case series of patients that underwent a surgical procedure to correct NV stenosis in the office setting. The procedure is described in detail along with patient outcome assessment using a visual analog scale of patient satisfaction and a questionnaire regarding perceived postoperative cosmetic changes.
  
  
  RESULTS
  Of 190 patients that underwent the procedure, 36 were done in the office setting and 28 completed the questionnaires. Six patients (21%) reported an improvement score of 10, a score of maximal improvement in breathing. The mean breathing score was 4.4, indicating an overall improvement in breathing ability after correction. No patient reported a major cosmetic change and three patients reported a subtle change. The remainder (89%) reported no perceived change in cosmesis.
  
  
  CONCLUSIONS
  In-office surgical correction of the NV specifically targeting the mucosa, fibrous tissue, and caudal upper lateral cartilage was feasible, safe, and reliable in relieving complaints of NO due to uncomplicated NV stenosis.
authors.affiliation: Department of Otolaryngology, Lahey Clinic, Burlington, Massachusetts, USA. robert.w.dolan@lahey.org
authors.forename: Robert W
authors.initials: RW
authors.lastname: Dolan
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Catalano
authors.forename: William
authors.initials: W
authors.lastname: Innis
authors.forename: Essam
authors.initials: E
authors.lastname: Wanees
mesh_terms: D000772:Anesthesia, Local; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000601:surgery*; D010045:Outpatients; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D013531:Surgicenters / Q000706:statistics & numerical data*; D013997:Time Factors; D016896:Treatment Outcome