Significance of Inner Nasal Valve In Septoplasty

2021 ◽  
Vol 8 (1) ◽  
pp. 3-8
Author(s):  
Dr. Shraddha Subhash Bhoyar ◽  
Dr. Gajanan Mohniraj Kashid ◽  
Dr. Ashok Gaikwad ◽  
Dr. Siddharth Ashok Purohit ◽  
Dr. Amit Shekhar Gupta ◽  
...  
Keyword(s):  
Retrospective Review ◽  
Symptomatic Improvement ◽  
Functional Improvement ◽  
Nasal Valve ◽  
Nasal Surgery ◽  
Spreader Graft ◽  
Persistent Symptoms ◽  
Septal Surgery ◽  
Valve Angle ◽  
Valve Area

Background: Nasal obstruction due to deviated septum is commonly treated with conventional septoplasty. This surgery however is inadequate in cases of compromised nasal valves and leads to persistent symptoms. Hence, we stressed the evaluation of nasal valves before septal surgery & studied the outcome of  the patients with valve area correction. Aim: To prove the significance of inner nasal valve in nasal surgery. Objective : To analyse the outcome of  Open septoplasty. Methodology:A  retrospective review of  our patients undergoing Open septoplasty was analysed from April 2016 to January 2021. The preoperative and post operative evaluations were calculated & statistically analysed. Results : A total of 400 patients underwent Open septoplasty. Out of which 392(98%) showed symptomatic improvement in breathing difficulty &   380(95%) were happy with the asthetic improvement.  Conclusion: Open septoplasty and Spreader grafts is best solution to improve Internal Nasal valve angle. Rim graft to improve external valve collapse. Spreader graft also gives asthetic & functional improvement

Spreader Graft for Severe Deviation of Nasal Septum with Obstruction of the Internal Nasal Valve: Clinical and Functional Results

2020 ◽  
Vol 36 (05) ◽  
pp. 635-642
Author(s):  
Leandro Albergo ◽  
Ernesto Desio ◽  
Velia Elena Revelli ◽  
Micaela B. Acosta
Keyword(s):  
Nasal Obstruction ◽  
Correct Diagnosis ◽  
Functional Results ◽  
Functional Improvement ◽  
Endonasal Approach ◽  
Nasal Valve ◽  
Spreader Graft ◽  
Symptom Evaluation ◽  
Valve Area

AbstractDifficulty in nasal ventilation is one of the most frequently occurring problems in otorhinolaryngology and its correct diagnosis is the key step to solve it. The dysfunctions in the valve area are a frequent cause of chronic nasal obstruction, though commonly ignored. The objective of the study is to analyze the clinical and functional outcomes in a group of patients with septal deviations and valve compromise treated with spreader graft with endonasal approach. Thirty-five patients with septal deviation with compromise of the internal nasal valve (INV; area II of Cottle), treated with spreader graft and a minimum follow-up of 12 months, were included for analysis. Patients were evaluated with video nasosinusal endoscopy, photography, the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire, and rhinomanometry (RM). Postoperative complications were recorded. The results obtained in the pre- and postoperative NOSE scores showed significant differences (p = 0.001), as also in pre- and postoperative RM tests (p < 0.001). Two complications were reported in the 35 patients; thus the complication rate in our sample was 6%. The use of spreader grafts, with endonasal approach, as nasal septum's tutors improved perpendicular septal deviations with compromise of the INV (area II), reaching an effective functional improvement in the nasal airway, with low rate of complications.

scholarly journals Computed tomography evaluation of internal nasal valve angle and area and its correlation with NOSE scale for symptomatic improvement in rhinoplasty

2020 ◽  
Vol 86 (3) ◽  
pp. 343-350 ◽  
Author(s):  
Amr G. Shafik ◽  
Hussam Adel Alkady ◽  
Gehad Mohamed Tawfik ◽  
Ahmed Mostafa Mohamed ◽  
Tahany Mohamed Rabie ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Symptomatic Improvement ◽  
Nasal Valve ◽  
Nose Scale ◽  
Valve Angle

A novel technique for spreader graft placement without dorsum resection during septoplasty

2015 ◽  
Vol 129 (10) ◽  
pp. 1025-1027 ◽  
Author(s):  
E Kaya ◽  
T Catli ◽  
H Soken ◽  
C Cingi
Keyword(s):  
Operation Time ◽  
Graft Material ◽  
Open Approach ◽  
Nasal Valve ◽  
Surgical Team ◽  
Spreader Graft ◽  
Graft Placement ◽  
Novel Technique ◽  
Novel Method ◽  
Valve Angle

AbstractObjective:This paper presents a novel method for spreader graft placement without dorsum resection in patients who have a deviated septum with a narrow internal nasal valve angle.Methods:A Killian incision was used for the endonasal septoplasty, and all spreader grafts were harvested from excised deviated septal cartilages. Procedures were conducted under general anaesthesia at the same centre by the same surgical team that performed the endonasal procedure. Successful placement of spreader grafts was achieved endonasally.Conclusion:Although the endonasal placement of spreader grafts seems to be more difficult than placement conducted by an open approach technique, an endonasal procedure has many advantages. Our technique provides surgeons with the opportunity to shorten operation time, obtain autologous septal graft material and secure the columellar architecture. Surgeons familiar with the classical (endonasal) septoplasty procedure can easily apply this technique to widen a narrow internal nasal valve angle, without corrupting nasal integrity.

Nasal Surgery in the Management of Sleep Apnea

1985 ◽  
Vol 94 (6) ◽  
pp. 550-554 ◽  
Author(s):  
Vijay S. Dayal ◽  
Eliot A. Phillipson
Keyword(s):  
Sleep Apnea ◽  
Subjective Improvement ◽  
Nasal Valve ◽  
Nasal Surgery ◽  
Obstructive Sleep ◽  
Short And Long Term ◽  
Objective Improvement ◽  
Valve Area

We present our experience with short- and long-term beneficial results obtained from surgery of the nasal valve area in carefully selected patients with obstructive sleep apnea (OSA). In six cases reported here, surgical treatment resulted in subjective improvement in snoring and daytime somnolence. Objective improvement was noted in three patients who had nasal valve area obstruction. Although the role of surgery in patients with mild OSA needs further assessment, surgical correction of nasal valve area obstruction in patients with moderately severe to severe OSA appears clearly indicated.

Spreader Graft Versus Spreader Flap in Rhinoplasty: A Systematic Review and Meta-Analysis of Aesthetic and Functional Outcomes

2021 ◽  
Author(s):  
Seied Omid Keyhan ◽  
Hamid Reza Fallahi ◽  
Behzad Cheshmi ◽  
Mahdi Jafari Modrek ◽  
Shaqayeq Ramezanzade ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Nasal Valve ◽  
Spreader Graft ◽  
Nose Scale ◽  
Satisfaction Rate ◽  
Significant Difference ◽  
Spreader Flap ◽  
Valve Angle

Abstract Background Insufficient support of the nasal mid-vault during rhinoplasty can cause significant complications. Accordingly, surgeons recently pay much more attention to the preservation of nasal patency. The spreader graft is the gold standard technique for the reconstruction of nasal mid-vault. Objectives The objective of this study was to compare the spreader graft and spreader flap in terms of aesthetic and functional outcomes. Methods An inclusive search was performed using PubMed/Medline, Google Scholar, Cochrane Library databases up to April 2021. Multiple aesthetic and functional factors including dorsal aesthetic lines restoration, satisfaction rate, internal nasal valve angle improvement, nasal obstruction symptom evaluation (NOSE) scale, and active anterior rhinomanometry (AAR) were evaluated. Also, a meta-analysis was performed on included articles that provided adequate data for mentioned factors. Results After excluding papers that did not conform with the selection criteria, 10 articles with a total sample size of 567 cases with a mean age of 27.7 (range: 18- 65) were finally included. Analysis of the data revealed no statistically significant difference between the spreader graft and spreader flap techniques in terms of dorsal aesthetic lines restoration, internal nasal valve angle improvement, NOSE scale, and AAR. Conclusions However, in terms of satisfaction rate, the analyzes indicated that spreader graft has significantly superior aesthetic outcomes. Generally, in case of appropriately selected patients, there is no statistically significant difference between spreader graft and spreader flap techniques in terms of aesthetic and functional outcomes.

scholarly journals Our experience with spreader graft in septorhinoplasty by open approach

2018 ◽  
Vol 4 (3) ◽  
pp. 748
Author(s):  
Markandeya Tiwari ◽  
Surender Kumar ◽  
H. C. Goel ◽  
Carnegie De sa
Keyword(s):  
Nasal Obstruction ◽  
Functional Improvement ◽  
Saddle Nose ◽  
Open Approach ◽  
Nasal Valve ◽  
Functional Effect ◽  
Spreader Graft ◽  
Volumetric Expansion ◽  
Saddle Nose Deformity ◽  
External Nasal Deformity

<p class="abstract"><strong>Background:</strong> Spreader graft being one of the best method for volumetric expansion of internal nasal angle to address the nasal valve pathologies, popularised by Sheen.</p><p class="abstract"><strong>Methods:</strong> To evaluate its functional effect on relieving nasal obstruction secondary to nasal valve pathologies, our study was conducted in 40 patients (35 male and 5 female; mean age 28 years) having both external nasal deformity and nasal obstruction. NOSE scale was used to assess functional improvement.  </p><p class="abstract"><strong>Results:</strong> Out of total 40 patients (22 patients with saddle nose deformity, 10 crooked nose and 8 nasal dorsum deformity), 35 patients (87.5%) were fully satisfied with functional outcome as assessed by NOSE score.</p><p><strong>Conclusions:</strong> Spreader graft is good way to handle nasal obstruction secondary to narrow internal nasal angle. </p>

scholarly journals Functional and aesthetic outcomes of spreader graft and auto-spreader flap after nasal hump removal

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Maged Baher Naguib ◽  
Mohamed Rifaat Ahmed ◽  
Yasser Taha Madian ◽  
Tarek Mohamady Elnahriry ◽  
Wael Elshahat Eldeeb
Keyword(s):  
Nasal Obstruction ◽  
Operative Time ◽  
Nasal Valve ◽  
Spreader Graft ◽  
Spreader Flap ◽  
The Mean ◽  
The Difference ◽  
A New Technique ◽  
Nasal Valve Collapse ◽  
Duration Of Operation

Abstract Background Following the reduction of the nasal hump to a desired level, spreader grafts are usually positioned to prevent the complication of nasal valve collapse. Auto-spreader flap is a new technique that gained more popularity recently and can be used as an alternative to spreader graft. This RCCT compared between both techniques aesthetically and functionally as well as the operative time. Results Forty patients, 17 males (42.5%) and 23 females (57.5%), were included. The mean duration of operation in auto-spreader flap was 11.8 ± 3.4 min, while it was 19.2 ± 3.2 min in spreader graft. The difference between the two procedures was statistically significant (P < 0.05). Functional assessment of nasal obstruction was done for all patients in both groups preoperative that was (75.6 ± 19.9) which showed marked improvement when re-evaluated 3 moths postoperatively (18.9 ± 14.7), and after 6 months NOSE scale was (29.1 ± 20.2). The overall aesthetic satisfaction was 62.5% (25 of 40) irrespective of the surgery done. Sixteen out of 20 patients in spreader group and 9 out of 20 in auto-spreader flap group. Conclusion Auto-spreader flap and spreader graft are very effective surgical procedure for treatment of nasal obstruction due to internal nasal valve dysfunction, but the auto-spreader flap had shorter operative time. However, spreader graft has a superior aesthetic outcome.

scholarly journals Expectancies as predictors of symptom improvement after antimicrobial therapy for persistent symptoms attributed to Lyme disease

2021 ◽  
Author(s):  
Henriët van Middendorp ◽  
Anneleen Berende ◽  
Fidel J. Vos ◽  
Hadewych H. M. ter Hofstede ◽  
Bart Jan Kullberg ◽  
...  
Keyword(s):  
Lyme Disease ◽  
Treatment Success ◽  
Symptomatic Improvement ◽  
Post Treatment ◽  
Symptom Improvement ◽  
Persistent Symptoms ◽  
Treatment Expectancies ◽  
End Of Treatment ◽  
Pre Treatment

Abstract Introduction/Objective Expectancies about symptom improvement or deterioration are reliable predictors of symptom progression and treatment outcomes (symptom resolution or symptomatic improvement) in many (non-)pharmacological studies and treatments. This study examined predictors of symptom improvement after antimicrobial therapy for persistent symptoms attributed to Lyme disease, hypothesizing particularly pre-treatment expectancies regarding symptom improvement to be predictive. Methods A predictive study was performed on pre-treatment and post-treatment individual characteristics, including expectancies, and physical and mental health–related quality of life (HRQoL) from the PLEASE-trial comparing randomized 12-weeks of doxycycline, clarithromycin-hydroxychloroquine, or placebo following 2 weeks of intravenous ceftriaxone. At end-of-treatment (14 weeks after trial start) and follow-up (52 weeks), complete data of 231 and 170 (of initial 280) patients with persistent symptoms temporally related to a history of erythema migrans or otherwise confirmed symptomatic Lyme disease, or accompanied by B. burgdorferi IgG or IgM antibodies, were examined through hierarchical regression analyses. Results In addition to pre-treatment HRQoL, pre-treatment expectancies regarding symptom improvement were consistently associated with stronger physical and mental HRQoL improvements at both end-of-treatment and follow-up (95% CI range: .09;.54, p < .01 to .27;.92, p < .001). Post-treatment expectancies regarding having received antibiotics vs. placebo was associated with more HRQoL improvement at end-of-treatment, but not at follow-up (95% CI-range 1.00;4.75, p = .003 to −7.34; −2.22, p < .001). Conclusions The present study shows that, next to pre-treatment functioning, patients’ pre-treatment and post-treatment expectancies regarding improvement of persistent symptoms attributed to Lyme disease relate to a more beneficial symptom course. Expectancies of patients may be relevant to explain and potentially improve patient outcomes (e.g., by optimized communication about treatment success). Trial registration ClinicalTrials.gov, NCT01207739 (Registration date: 23–09-2010) Key Points• As there is currently no sufficient symptom resolution or symptomatic improvement for many patients with persistent symptoms attributed to Lyme disease, it is relevant to know which factors determine symptom progression and predict heterogeneity in treatment response.• Next to pre-treatment functioning, expectancies regarding symptom improvement and having received antimicrobial study medication are associated with a more beneficial symptom course after both shorter-term and longer-term antimicrobial treatment.• Expectancies are relevant to consider in treatment studies and may be useful in clinical settings to improve symptom course and treatment outcome (e.g., by optimized communication about treatment success).

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