PMID- 25675172
OWN - NLM
STAT- MEDLINE
DCOM- 20160229
LR  - 20220410
IS  - 2168-6092 (Electronic)
IS  - 2168-6076 (Linking)
VI  - 17
IP  - 2
DP  - 2015 Mar-Apr
TI  - Airflow and patient-perceived improvement following rhinoplastic correction of 
      external nasal valve dysfunction.
PG  - 131-6
LID - 10.1001/jamafacial.2014.1456 [doi]
AB  - IMPORTANCE: External nasal valve dysfunction (ENVD) is a common cause of nasal 
      obstruction. Although many techniques are described to help correct ENVD, 
      evidence of the objective changes in the airway achieved by these interventions 
      is mainly unknown. OBJECTIVE: To document the airway changes in patients with 
      ENVD by comparing subjective and objective measures obtained before and after 
      rhinoplasty. DESIGN, SETTING, AND PARTICIPANTS: Prospective case series with 
      validated subjective and objective outcomes at a tertiary rhinologic center in 
      Sydney, Australia. We included 19 patients with nasal obstruction and clinically 
      diagnosed ENVD from January 2012 to May 2013. INTERVENTIONS: Functional 
      reconstructive rhinoplasty involving lateral crural underlay strut grafts using 
      costal cartilage or lateral crural cephalic turn-in maneuvers performed to 
      correct ENVD. MAIN OUTCOMES AND MEASURES: Objective assessment included nasal 
      peak inspiratory flow, nasal airway resistance, and minimum cross-sectional area. 
      Subjective assessment included a visual analog scale for nasal obstruction, the 
      22-item Sinonasal Outcome Test, the Nasal Obstruction Symptom Evaluation Scale, 
      and the 36-Item Short Form Health Survey, version 2. A 13-point Likert scale was 
      also used to assess overall function and cosmesis. Objective data and visual 
      analog scale scores were obtained before and after decongestion at baseline and 6 
      months after surgery. RESULTS: Mean (SD) age of the patients undergoing 
      assessment was 33.3 (12.4) years; 13 patients (68%) were female. Significant 
      improvement was observed in scores for the Sinonasal Outcome Test (mean [SD] 
      change, 0.85 [0.96]), Nasal Obstruction Symptom Evaluation Scale (mean [SD] 
      change, 30.53 [26.14]), and overall function (median [25th-75th percentiles] 
      change, -6.5 [-7.0 to 1.0]) and cosmesis (median [25th-75th percentiles] change, 
      -4.0 [-8.0 to -1.0]) (P < .01). The mean (SD) nasal peak inspiratory flow 
      increased from 102.6 (45.6) to 124.0 (52.9) L/min (P < .01). Median (25th-75th 
      percentiles) nasal airway resistance showed no significant change (from 0.296 
      [0.237-0.414] to 0.292 [0.267-0.371] Pa/cm3/s; P = .92). The minimum 
      cross-sectional area also showed no significant change (mean [SD], from 1.188 
      [0.407] to 1.229 [0.336] cm2; P = .69). CONCLUSIONS AND RELEVANCE: Contrary to 
      common belief, successful rhinoplasty had little effect on structural shape or 
      resistance in ENVD, but symptoms improved with changes in collapsibility as 
      defined by the nasal peak inspiratory flow. The need to reconstruct lateral wall 
      support is reinforced by the data presented. LEVEL OF EVIDENCE: 4.
FAU - Palesy, Tom
AU  - Palesy T
AD  - Faculty of Medicine, St Vincent's Clinical School, University of New South Wales, 
      Sydney, Australia.
FAU - Pratt, Eleanor
AU  - Pratt E
AD  - Rhinology and Skull Base Research Group, Applied Medical Research Centre, 
      University of New South Wales and Macquarie University, Sydney, Australia.
FAU - Mrad, Nadine
AU  - Mrad N
AD  - Rhinology and Skull Base Research Group, Applied Medical Research Centre, 
      University of New South Wales and Macquarie University, Sydney, Australia.
FAU - Marcells, George N
AU  - Marcells GN
AD  - Sydney Hospital and Bondi Junction Private Hospital, Sydney, Australia.
FAU - Harvey, Richard J
AU  - Harvey RJ
AD  - Rhinology and Skull Base Research Group, Applied Medical Research Centre, 
      University of New South Wales and Macquarie University, Sydney, Australia.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - JAMA Facial Plast Surg
JT  - JAMA facial plastic surgery
JID - 101589532
SB  - IM
MH  - Adult
MH  - Australia
MH  - Cartilage/transplantation
MH  - Female
MH  - Humans
MH  - Male
MH  - Nasal Obstruction/*surgery
MH  - Prospective Studies
MH  - Rhinoplasty/*methods
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
EDAT- 2015/02/13 06:00
MHDA- 2016/03/02 06:00
CRDT- 2015/02/13 06:00
PHST- 2015/02/13 06:00 [entrez]
PHST- 2015/02/13 06:00 [pubmed]
PHST- 2016/03/02 06:00 [medline]
AID - 2107334 [pii]
AID - 10.1001/jamafacial.2014.1456 [doi]
PST - ppublish
SO  - JAMA Facial Plast Surg. 2015 Mar-Apr;17(2):131-6. doi: 
      10.1001/jamafacial.2014.1456.