title: The effectiveness of modified cottle maneuver in predicting outcomes in functional rhinoplasty.
abstract: Objective. To assess the outcomes of functional rhinoplasty for nasal valve incompetence and to evaluate an in-office test used to select appropriate surgical techniques. Methods. Patients with nasal obstruction due to nasal valve incompetence were enrolled. The modified Cottle maneuver was used to assess the internal and external nasal valves to help select the appropriate surgical method. The rhinoplasty outcomes evaluation (ROE) form and a 10-point visual analog scale (VAS) of nasal breathing were used to compare preoperative and postoperative symptoms. Results. Forty-nine patients underwent functional rhinoplasty evaluation. Of those, 35 isolated batten or spreader grafts were inserted without additional procedures. Overall mean ROE score increased significantly (P < 0.0001) from 41.9 ± 2.4 to 81.7 ± 2.5 after surgery. Subjective improvement in nasal breathing was also observed with the VAS (mean improvement of 4.5 (95% CI 3.8-5.2) from baseline (P = 0.000)). Spearman rank correlation between predicted outcomes using the modified Cottle maneuver and postoperative outcomes was strong for the internal nasal valve (Rho = 0.80; P = 0.0029) and moderate for the external nasal valve (Rho = 0.50; P = 0.013). Conclusion. Functional rhinoplasty improved subjective nasal airflow in our population. The modified Cottle maneuver was effective in predicting positive surgical outcomes.
authors.affiliation: Department of Surgery, Dalhousie University, 5850 University Avenue, Halifax, NS, Canada B3H 2Y9 ; Department of Surgery, IWK Health Centre, 5850/5920 University Avenue, P.O. Box 9700, Halifax, NS, Canada B3K 6R8.
authors.forename: Elaine
authors.identifier: 0000-0003-1485-6515
authors.initials: E
authors.lastname: Fung
authors.affiliation: Department of Surgery, Dalhousie University, 5850 University Avenue, Halifax, NS, Canada B3H 2Y9 ; Department of Surgery, IWK Health Centre, 5850/5920 University Avenue, P.O. Box 9700, Halifax, NS, Canada B3K 6R8.
authors.forename: Paul
authors.identifier: 0000-0002-8766-3266
authors.initials: P
authors.lastname: Hong
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Western Ontario, London, ON, Canada N6B 2P2.
authors.forename: Corey
authors.initials: C
authors.lastname: Moore
authors.affiliation: Department of Surgery, Dalhousie University, 5850 University Avenue, Halifax, NS, Canada B3H 2Y9 ; Department of Surgery, IWK Health Centre, 5850/5920 University Avenue, P.O. Box 9700, Halifax, NS, Canada B3K 6R8.
authors.forename: S Mark
authors.initials: SM
authors.lastname: Taylor