Evaluation of Improvement in Nasal Obstruction Following Nasal Valve Correction in Patients With a History of Failed Septoplasty

Chambers, Kyle J.; Horstkotte, Kate A.; Shanley, Kerry; Lindsay, Robin W.

doi:10.1001/jamafacial.2015.0978

Cited by 63 publications

(63 citation statements)

References 16 publications

(23 reference statements)

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“…The static component in nasal valve dysfunction is commonly treated with spreader grafts and extracorporeal septal reconstruction . Dynamic nasal valve collapse (NVC), although as common as septal deviation and inferior turbinate hypertrophy, is often underdiagnosed and left untreated . Batten grafts, bone‐anchored sutures, and lateral crural strut grafts are common methods in functional rhinoplasty to address dynamic NVC.…”

Section: Introductionmentioning

confidence: 99%

Twelve‐month outcomes of a bioabsorbable implant for in‐office treatment of dynamic nasal valve collapse

Sidle

Stolovitzky

et al. 2019

The Laryngoscope

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Objectives: To examine 12-month outcomes for in-office treatment of dynamic nasal valve collapse (NVC) with a bioabsorbable implant.Study Design: Prospective, multicenter, nonrandomized study. Methods: One hundred sixty-six patients with severe-to-extreme class of Nasal Obstruction Symptom Evaluation (NOSE) scores were enrolled at 16 U.S. clinics (November 2016-July 2017). Patients were treated with a bioabsorbable implant (Latera, Spirox Inc., Redwood City, CA) to support the lateral wall, with or without concurrent inferior turbinate reduction (ITR), in an office setting. NOSE scores and Visual Analog Scale (VAS) were measured at baseline and 1, 3, 6, and 12 months postoperatively. The Lateral Wall Insufficiency (LWI) score was determined by independent physicians observing the lateral wall motion video.Results: One hundred five patients were treated with implant alone, whereas 61 had implant + ITR. Thirty-one patients reported 41 adverse events, all of which resolved with no clinical sequelae. Patients showed significant reduction in NOSE scores throughout 12 months postoperatively (77.4 AE 13.4 baseline vs. 36.2 AE 22.7 at 1 month postoperatively, 33.0 AE 23.4 at 3 months, 32.1 AE 24.6 at 6 months, and 30.3 AE 24.3 at 12 months; P < 0.001). They also showed significant reduction in VAS scores postoperatively (69.7 AE 18.1 baseline vs. 31.3 AE 27.1 at 12 months postoperatively, P < 0.001). These results were similar in patients treated with implant alone and those treated with the implant + ITR. Consistent with patient-reported outcomes, postoperative LWI scores were demonstrably lower (1.42 AE 0.09 and 0.93 AE 0.08 pre-and postoperatively, P < 0.001).Conclusion: In-office treatment of dynamic NVC with a bioabsorbable implant improves clinical evidence of LWI at 6 months and improves nasal obstructive symptoms in a majority of patients up to 12 months.

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Section: Introductionmentioning

confidence: 99%

Twelve‐month outcomes of a bioabsorbable implant for in‐office treatment of dynamic nasal valve collapse

Sidle

Stolovitzky

et al. 2019

The Laryngoscope

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“…However, the ideal follow‐up duration after functional septorhinoplasty has not yet been determined. Previous literature utilizing NOSE scores report variable follow‐up, ranging from 1 month to 4 years …”

Section: Introductionmentioning

confidence: 99%

Nasal obstruction symptom evaluation (NOSE) score outcomes after septorhinoplasty

et al. 2018

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Objectives/Hypothesis The time interval at which Nasal Obstruction Symptom Evaluation (NOSE) scores stabilize after functional septorhinoplasty has not been determined. Our goal was to characterize longitudinal trends of patient‐reported outcomes of nasal obstruction using the NOSE survey instrument following functional septorhinoplasty. Study Design Prospective longitudinal cohort study. Methods Adult patients (≥18 years) with nasal obstruction who underwent functional septorhinoplasty by three different surgeons at a single academic, tertiary referral center were identified. NOSE scores were obtained preoperatively and prospectively during three postoperative intervals defined as early (1–3 months), middle (4–6 months), and late (≥10 months.) Longitudinal analysis included repeated measures analysis of variance and adjustments for multiple comparisons. Results A total of 49 patients met inclusion criteria. For the total cohort, mean NOSE scores significantly improved between preoperative and early postoperative evaluations (71.4, standard deviation [SD] ± 17.0 vs. 24.2, SD ± 19.5; P < .001) but did not significantly change between early and middle (20.6, SD ± 19.1; P = .543) or middle and late (23.1, SD ± 24.9; P > .999) time intervals. Conclusions Patients with nasal obstruction who undergo functional septorhinoplasty can be expected to have significant improvement in self ‐reported nasal obstruction as early as 1 to 3 months postoperatively with a continued, durable, long‐standing benefit lasting at least 10 months after surgery. Future studies can consider the 3‐month time frame as a proxy for 1 year outcomes to help reduce survey burden. Level of Evidence 2c Laryngoscope, 129:841–846, 2019

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“…Nasal valve correction using spreader grafts in another nasal obstruction population showed similar outcomes, who had preoperative NOSE scores of over 80 and postoperative scores reaching 22.2. 26 A study using a homemade questionnaire also showed significant improvement in nasal symptom scores after autospreader grafting. 18 These…”

Section: Discussionmentioning

confidence: 95%

The Autospreader Flap for Midvault Reconstruction following Dorsal Hump Resection

Moubayed

Most

2016

Facial plast Surg

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Dorsal hump reduction without adequate reconstitution of the midvault can often result in cosmetic or functional problems. One of the simplest techniques to avoid these problems is the use of the excess upper lateral cartilage to reconstruct the midvault (the spreader flap or autospreader). Herein we outline the history of the technique and present the specific indications and contraindications, as well as describe our method for achieving it successfully. Case studies are presented with the specific indications. Grafting alternatives to the spreader flap are also outlined. The spreader flap technique offers multiple advantages, including maximal use of local tissues, simplicity, and airway preservation. Disadvantages are the use of an external approach and the inability to use it alone in the presence of severe asymmetries.

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Evaluation of Improvement in Nasal Obstruction Following Nasal Valve Correction in Patients With a History of Failed Septoplasty

Cited by 63 publications

References 16 publications

Twelve‐month outcomes of a bioabsorbable implant for in‐office treatment of dynamic nasal valve collapse

Twelve‐month outcomes of a bioabsorbable implant for in‐office treatment of dynamic nasal valve collapse

Nasal obstruction symptom evaluation (NOSE) score outcomes after septorhinoplasty

The Autospreader Flap for Midvault Reconstruction following Dorsal Hump Resection

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