title: External nasal valve collapse repair: the limited alar-facial stab approach.
abstract: OBJECTIVE
  Permanent treatment for external nasal valve collapse (ENCV) is primarily surgical. In some situations, instead of a major operation, the placement of structural alar rim graft may be all that is needed. Alar rim graft placement is usually achieved through a marginal incision as a part of a rhinoplasty. We compared the aesthetic and functional outcomes of a simple technique in which the graft is placed via an external incision in the alar-facial groove with the outcomes of the more commonly used method.
  
  
  METHODS
  All patients who underwent ENCV repair in 2007 and 2008 were reviewed. Fifteen cases in which grafts were placed using the alar-facial stab technique were identified. Twenty cases with marginal incision graft placement in that time period were then randomly selected. All of the patients underwent concurrent additional procedures such as rhinoplasty/septorhinoplasty. The aesthetic and functional assessments of both techniques were explored by means of blinded observers rating the aesthetic outcome and patients rating their functional outcome through the use of questionnaires.
  
  
  METHODS
  A retrospective cohort study.
  
  
  RESULTS
  A comparison between the patients' subjective results showed no difference between the outcomes of these two techniques (P > .05). The blinded surgeon evaluators could not differentiate between the different approaches utilized in the vast majority of cases studied.
  
  
  CONCLUSIONS
  The alar-facial stab incision with alar rim grafting for treatment of ENCV is a very simple and effective technique that does not require significant rhinoplasty experience and may be performed in the office under local anesthesia.
authors.affiliation: Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Armin Farajzadeh
authors.initials: AF
authors.lastname: Deroee
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Younes
authors.forename: Oren
authors.initials: O
authors.lastname: Friedman
mesh_terms: D002356:Cartilage / Q000637:transplantation*; D015331:Cohort Studies; D004210:Dissection / Q000379:methods; D004954:Esthetics; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D015508:Nasal Obstruction / Q000601:surgery*; D009668:Nose Diseases / Q000601:surgery*; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*