Anatomical comparison of minimally invasive nasal valve procedures.
OBJECTIVE
To determine the quantitative effects of Z-plasty vs spreader grafts on nasal valve surface area.


METHODS
Eight fresh cadaver heads were used that provided 16 total nasal valve procedures. Surgical sides were randomized, and Z-plasty was performed on 8 valves and endonasal spreader grafts were performed on 8 valves. The minimal cross-sectional area at the level of the nasal valve was measured preoperatively and postoperatively using acoustic rhinometry. We then compared Z-plasty and spreader grafts using a Wilcoxon signed rank test.


RESULTS
The mean nasal surface area at the nasal valve before Z-plasty was 1.37 cm(2) (range, 0.39-2.25 cm(2)) and after Z-plasty was 1.95 cm(2) (range, 1.08-2.62 cm(2)). The mean surface area at the nasal valve before spreader grafts was 1.15 cm(2) (range, 0.75-1.48 cm(2)) and after spreader grafts was 1.48 cm(2) (0.95-1.95 cm(2)). This correlates with a mean increase in the nasal valve surface area of 65% when Z-plasty was performed (95% CI, 28%-88%; P = .007) and 31% when a spreader graft was performed (95% CI, 15%-54%; P = .01).


CONCLUSIONS
Z-plasty and spreader grafts were shown to increase nasal valve surface area. Z-plasty seems to increase nasal valve surface area more than spreader grafts.
Department of Otolaryngology–Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois 60612, USA. david_weeks@rush.edu
David M
DM
Weeks
David D
DD
Walker
Jay M
JM
Dutton
D006801:Humans; D009296:Nasal Cavity / Q000033:anatomy & histology / Q000601:surgery*; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D012225:Rhinoplasty / Q000379:methods*; D013524:Surgical Flaps; D013536:Suture Techniques