Evaluation of pre- and post-pyriform plasty nasal airflow

Sofia, Oscimar Benedito; Neto, Ney P. Castro; Katsutani, Fernando S.; Mitre, Edson Ibrahim; Dolci, José Eduardo Lutaif

doi:10.1016/j.bjorl.2017.03.013

Cited by 7 publications

(10 citation statements)

References 12 publications

(12 reference statements)

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“…The NOSE questionnaire was selected as it is the most widely used validated questionnaire; [ 12 ] it is a responsive and disease-specific assessment tool that can quantitatively assess nasal obstructive symptoms in our study cohort [ 4 , 5 , 25 – 27 ]. The NOSE instrument been recently used in patients undergoing nasal valve correction surgery in evaluating for subjective improvements in nasal obstructive symptoms [ 7 , 8 , 28 – 31 ].…”

Section: Discussionmentioning

confidence: 99%

Reliability and construct validity of the Ottawa valve collapse scale when assessing external nasal valve collapse

Ziai

Bonaparte

2018

J of Otolaryngol - Head & Neck Surg

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BackgroundNasal valve collapse is a common cause of nasal obstruction in otolaryngology practice. Common examination methods, such as the Cottle Maneuver and modified Cottle Maneuver are available. However, these methods are dichotomous and do not provide ordinal severity information. The Ottawa Valve Collapse Scale (OVCS) is a grading system for assessing and easily grading external nasal valve collapse in patients with a septal deviation. The primary objective was to assess the test-retest reliability and construct validity of the OVCS grading scale. A secondary objective was to perform the same assessments on the Cottle Maneuver.MethodsPatients with a septal deviation who were requesting surgical correction were prospectively enrolled in the study. All patients were assessed using both the Cottle Maneuver and the OVCS by one otolaryngologist at two visits separated by one month. The phi coefficient was calculated to assess the test-retest reliability of the instruments. Results of the Nasal Obstruction Symptom Evaluation (NOSE) Score was compared to determine construct validity.ResultsNinety-two patients met our inclusion criteria. The phi coefficient was 0.62 for the OVCS and 0.32 for the Cottle Maneuver. The scores on the NOSE instrument were positively associated with the OVCS scores (p = 0.01) while there was no association with the Cottle Maneuver (p = 047).ConclusionThis current preliminary analysis suggests that the novel Ottawa Valve Collapse Scale has good test-retest reliability and construct validity. This scale may help clinicians grade external nasal valve collapse in patients with a septal deviation. Future studies are required to determine if this scale assists surgeons in determining which patients need formal nasal valve surgery in addition to a standard septoplasty.

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Section: Discussionmentioning

confidence: 99%

Reliability and construct validity of the Ottawa valve collapse scale when assessing external nasal valve collapse

Ziai

Bonaparte

2018

J of Otolaryngol - Head & Neck Surg

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“…Three authors used the sublabial approach and resected the lower portion of the PA rim, below the bony root of the IT 17,19,22 ( Figure 2). One of these authors also resected the midportion of the PA, above the bony root of the inferior turbinate 17 .…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, benefit from pyriplasty is expected to vary with indications and surgical techniques. However, excessively narrow PA (maximum width below 17 mm) seems to be a logical indication for pyriplasty, as illustrated by Erdem et al, 17 and objective decrease of nasal resistance after low‐level pyriplasty has been demonstrated by Sofia et al 22 A CFD study from Simmen et al 21 also demonstrated objective improvement of airflow throughout the entire nose after mid‐level pyriplasty, which lateralized IT’s head.…”

Section: Discussionmentioning

confidence: 96%

“…[28][29][30] Interestingly, nasal obstruction improvement has been reported by 2 other authors in that indication. 18,22 In our opinion, further studies are mandatory before proposing pyriplasty as a primary procedure for lateral nasal wall collapse. However, pyriplasty might be useful as a secondary procedure after failed functional rhinoplasty.…”

Section: Indicationsmentioning

confidence: 98%

“…[14][15][16] Indeed, recent publications suggested potential efficiency of pyriplasty in selected cases of INV obstruction. [17][18][19][20][21][22][23] Therefore, the aim of our study was to perform a systematic review of the literature about pyriplasty in order to analyze current surgical techniques, suggested indications, and related outcome in terms of success and complications.…”

mentioning

confidence: 99%

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Pyriform Aperture Enlargement for Internal Nasal Valve Obstruction in Adults: Systematic Review and Surgical Classification

Hajem

Botter

Omani

et al. 2021

Otolaryngol.--head neck surg.

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Objective Pyriform aperture enlargement or “pyriplasty” is an uncommonly used procedure for internal nasal valve obstruction in adults besides functional rhinoplasty, inferior turbinate reduction, and septoplasty. A systematic review of the literature was performed to analyze current surgical techniques, their suggested indications, and their related outcome in terms of success and complications. Data Sources The search was performed on PubMed, EMBASE, SCOPUS, and Cochrane databases. Review Methods The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies on congenital, traumatic, tumoral, or infectious internal nasal valve obstruction were excluded. Results Eight articles were finally included. Three types of pyriplasty have been described according to the level of bone resection: low-level pyriplasty through the sublabial approach, mid-level pyriplasty through endonasal approach, and extended pyriplasty through either approach. Indications included (1) clinically or radiologically narrow pyriform aperture, (2) previously unsuccessful internal nasal valve surgery, (3) lateral nasal wall collapse, and (4) inferior turbinate’s head hypertrophy. Subjective improvement of nasal obstruction was reported in these 4 indications. No major complication was encountered. Conclusion Pyriplasty for nasal obstruction is a simple and safe procedure that could be effective in selected cases. However, level of evidence is currently low, and success rate may vary with indications and pyriplasty techniques. Moreover, there is no clear definition of normal pyriform aperture dimensions to date. Further prospective studies are thereby necessary and should include radiological analysis of pyriform aperture and validated nasal obstruction measurement tools.

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Sinonasal Outcome After Endoscopic Transnasal Surgery—A Prospective Rhinological Study

Conrad

Blaese

Becker

et al. 2022

Operative Neurosurgery

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BACKGROUND:The sinonasal outcome after transnasal skull base surgery has often been neglected aside from major outcome criteria as extent of tumor resection, ophthalmological, and endocrinological parameters.OBJECTIVE:To analyze rhinological outcome after endoscopic transnasal neurosurgery.METHODS:Patients were treated using a middle turbinate–preserving transnasal endoscopic approach for sellar/parasellar lesions. As major variables, olfactory function and nose breathing ability were assessed. The study participants were investigated by odor testing (“Sniffin’ sticks”), rhinomanometry, and endoscopic inspection of the nasal cavity before and 6 months after surgery. Furthermore, sinonasal-associated quality of life was measured before, immediately and 6 months after surgery with a standardized questionnaire (SNOT-20-GAV).RESULTS:Eighty-two patients (47 male, 35 female, median age 55 years) matched the inclusion criteria. Before surgery, the average odor was found to be 30.75 (≥31 = normosmia); in the postinterventional examination at 6 months, the average increased to 33.08 (n.s.). Rhinomanometric examination of binostril nasal airflow showed an average of 590.42 mL/s on inspiration before and an increase to 729.78 mL/s at 6 months after surgery. SNOT-20 symptom scores had a maximum score right after and no difference at 6 months after surgery (scores 23.76 and 14.91 vs 15.53 before surgery).CONCLUSION:Based on the study, the endoscopic transnasal technique preserving the middle turbinate has no significant negative effects on the rhinological outcome.

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Evaluation of pre- and post-pyriform plasty nasal airflow

Abstract: When analyzing the results obtained in this study, we can conclude that the piriform plasty surgical procedure resulted in nasal airflow improvement in most of the obtained measurements.

Cited by 7 publications

References 12 publications

Reliability and construct validity of the Ottawa valve collapse scale when assessing external nasal valve collapse

Reliability and construct validity of the Ottawa valve collapse scale when assessing external nasal valve collapse

Pyriform Aperture Enlargement for Internal Nasal Valve Obstruction in Adults: Systematic Review and Surgical Classification

Sinonasal Outcome After Endoscopic Transnasal Surgery—A Prospective Rhinological Study

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