Combining Spreader Grafts with Suture Suspension for Management of Narrow Internal Nasal Valve Angles

Abstract

Objective:The present study aimed to evaluate the long-term results of combining spreader grafts with lateral suspension techniques for management of narrow internal nasal valves.Methods: This prospective study included 79 patients who underwent surgical interference for dysfunctional nasal valve. The surgical intervention was a combination of two commonly used techniques for management of internal nasal valve dysfunction: spreader graft insertion and lateral suspension of the upper lateral cartilages. The patients were assessed using the nasal obstruction symptom evaluation (NOSE) tool, computed tomography (CT) scans, and endoscopic examinations.Results: All patients reported initial improvement and satisfaction in nasal breathing. Seventy-two patients (91%) reported sustained relief of nasal breathing for at least 3 years postoperatively. The mean NOSE scores decreased from 69.8 to 20.65 postoperatively. The internal nasal valve angle, as measured endoscopically, increased from 7.23° to 13.05° on the right side and from 6.75° to 11.98° on the left side; the increase was statistically significant. The angle, as measured on axial CT scans, increased from 8.11° to 14.15° on the right side and from 6.98° to 12.13° on the left side’ this increase, too, was statistically significant.Conclusion: Combining spreader grafts with lateral suspension sutures provide good, stable, and sustained repair of dysfunctional narrowed internal nasal valves.

Keywords

• narrow nasal valve
• nasal spreader graft
• lateral cartilage suspension