title: Subjective and objective improvement in breathing after rhinoplasty.
abstract: OBJECTIVE
  To determine whether rhinoplasty improves subjective and objective nasal patency.
  
  
  METHODS
  Retrospective study including subjective breathing scores and acoustic rhinometry before and 6 to 9 months after septorhinoplasty among a cohort of 31 patients. We used a paired t test to analyze the difference between preoperative and postoperative values.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Patients undergoing septorhinoplasty with potassium titanyl phosphate laser turbinate reduction at a single institution.
  
  
  RESULTS
  The mean subjective breathing scores improved significantly, with an overall improvement of 38%. The overall mean volume increased and the overall resistance decreased, but the changes were significant only on the right side. The minimal cross-sectional area (MCA) did not change, but the distance of the MCA of the nasal cavity moved anteriorly by 0.23 cm on the left side. The patients were stratified into subsets based on other procedures undergone, including spreader grafts and alar batten grafts, and on the absence of osteotomies. These groups had similar results. In patients with severe obstruction, all measured values improved more than any other subgroup, including the MCA, which improved significantly by an average of 55%. Patients with normal preoperative MCA values did not experience any significant changes except for an anterior shift in MCA.
  
  
  CONCLUSIONS
  Septorhinoplasty increases nasal volume, decreases nasal resistance, and advances the MCA anteriorly. These changes coexist with subjective improvements in nasal patency, which suggests that this new anatomic configuration creates a positive outcome on nasal airflow. Spreader grafts do not increase the MCA significantly. Patients with preoperative severe obstruction have the best overall improvement, whether measured subjectively or objectively.
authors.affiliation: Department of Otolaryngology–Head and Neck Surgery, Cedars Sinai Medical Center, 9401 Wilshire Blvd, Beverly Hills, CA 90212, USA. DrZ@BHfaceMD.com
authors.forename: Richard A
authors.initials: RA
authors.lastname: Zoumalan
authors.forename: Minas
authors.initials: M
authors.lastname: Constantinides
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000601:surgery*; D009300:Nasal Septum / Q000601:surgery; D012119:Respiration; D012189:Retrospective Studies; D023842:Rhinometry, Acoustic; D012225:Rhinoplasty / Q000379:methods; D016896:Treatment Outcome; D014420:Turbinates / Q000601:surgery; D055815:Young Adult