title: Costal Cartilage Lateral Crural Strut Graft vs Cephalic Crural Turn-in for Correction of External Valve Dysfunction.
abstract: OBJECTIVE
  External nasal valve dysfunction (EVD) is a common cause of nasal obstruction.
  
  
  OBJECTIVE
  To evaluate costal cartilage lateral crural strut grafts vs cephalic crural turn-in to support the weak lateral crus in patients with EVD.
  
  
  METHODS
  In this prospective cohort study, patients with clinically diagnosed EVD were assessed at the Tertiary Rhinologic Center and underwent a costal cartilage underlay graft to the lateral crus or a cephalic turn-in cruralplasty.
  
  
  METHODS
  Assessment of patient benefit was based on 22-Item Sinonasal Outcome Test (SNOT-22) and Nasal Obstruction Symptom Evaluation Scale (NOSE) scores. A Likert scale was also used to assess overall function and cosmesis. Objective assessment included postdecongestion nasal peak inspiratory flow, nasal airway resistance, and minimum cross-sectional area.
  
  
  RESULTS
  Forty-one patients (mean [SD] 35.38 [12.73] years of age; 25 [61%] female) were assessed. Cephalic turn-in maneuver was used for 25 (61%) patients; costal cartilage lateral crural strut grafts, 16 (39%) patients. Costal cartilage grafts were used in patients undergoing revision but other baseline data were similar. Follow-up was mean 10.58 (7.52) months. All patients had significantly improved visual analog scale, SNOT-22, NOSE, patient-reported function, and cosmesis scores. The only objective test that improved was nasal peak inspiratory flow (114.76 [60.48] L/min vs 126.46 [61.17] L/min; P = .02).
  
  
  CONCLUSIONS
  Both techniques were effective in improving patient-reported outcomes and nasal peak inspiratory flow. Both are functionally and cosmetically viable options for correction of EVD.
  
  
  METHODS
  2.
authors.affiliation: Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales and Macquarie University, New South Wales, Australia2Bondi Junction Private Hospital, Bondi Junction, New South Wales, Australia.
authors.forename: Henry P
authors.initials: HP
authors.lastname: Barham
authors.affiliation: Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales and Macquarie University, New South Wales, Australia2Bondi Junction Private Hospital, Bondi Junction, New South Wales, Australia.
authors.forename: Anna
authors.initials: A
authors.lastname: Knisely
authors.affiliation: Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales and Macquarie University, New South Wales, Australia.
authors.forename: Jenna
authors.initials: J
authors.lastname: Christensen
authors.affiliation: Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales and Macquarie University, New South Wales, Australia.
authors.forename: Raymond
authors.initials: R
authors.lastname: Sacks
authors.affiliation: Bondi Junction Private Hospital, Bondi Junction, New South Wales, Australia.
authors.forename: George N
authors.initials: GN
authors.lastname: Marcells
authors.affiliation: Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales and Macquarie University, New South Wales, Australia.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Harvey
mesh_terms: D000328:Adult; D066186:Costal Cartilage / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D055171:Nasal Cartilages / Q000601:surgery*; D015508:Nasal Obstruction / Q000209:etiology / Q000601:surgery*; D011446:Prospective Studies; D012086:Reoperation; D012225:Rhinoplasty / Q000379:methods*; D016896:Treatment Outcome