roblems with the nasal valve are easily overlooked unless one delib
erately and consciously seeks to evaluate them. Thirteen percent of pa
tients presenting with nasal obstruction have nasal valve pathology as
an associated etiology. The aim of this study was to evaluate the effica
cy of supero-lateral nasal valve pull-up as a method for treating the ob
structed nasal breathing caused by nasal valve dysfunction. Subjects
and Methods: A nonrandomized study of 32 patients with symptoms of
obstructed nasal breathing. The follow-up duration ranged from 5-to 12
months. The inclusion criteria were: 1) Obstructed breathing with medial
displacement of the nasal valve complex. 21A significant nasal valve in
ward displacement during inspiration. 3) A lack of response to medical
and/or surgical correction of other factors associated with the 2 previous
criteria. 4) A positive Cottle's sign. The nasal valve was pulled-up
with 2 permanent 4-0 polypropylene sutures and fixed superolatercdly
to the maxillary periosteum and the overlying soft tissue. The point of
suspension is midway between the inner canthus and the junction
of the piriform aperture and the cheek. Subjective self assessment
scores were collected on a 10-point scale (10 as worst! for nasal block
age, headache, snoring, perceived activity restriction from nasal airway
obstruction (tiredness) and hyposmia. The objective data were obtained
by nasal endoscopy and photographic analysis of the nasal valve angle
(NVA). Results: All patients reported improvement of nasal blockage.
The mean NVA showed significant postoperative increase with significant
correlation to the improvement in nasal blockage score. The score is inuersely
proportion al to the angle degree. The surgery markedly im
proved patients' headache (84% of patients), |
