Impact of dome splitting on the nasal airfl ow effi cacy of external airway

Abstract

Dome splitting is effective technique in the nasal tip surgery indicated for the reduction of tip projection, increasing tip rotation, domal arch narrowing and correction of the lobule asymmetry. However, there are concerns regarding its negative effects on nasal airfl ow. The present study compared the effect of rhinoplasty with the dome splitting on the effi cacy of external nasal airfl ow. In a prospective before and after clinical trial, 46 eligible patients (39 females, 6 males) were selected and standardized images of their nasal bases were obtained during normal and deep breathes before and 3 months after the surgery. Patients were subjected to rhinoplasty with open technique and dome splitting was done in the nasal lower cartilage between lateral and medial crura. The area of the nasal external airway was measured during normal and deep breathes before and 3 months after the surgery. The percent of nasal airfl ow efficacy was determined qualitatively and quantitatively in the patients' left and right nostrils using McNemar and Wilcoxon Signed Ranks tests. In the left and right nostrils, 67.4% (31) of the patients, the airfl ow effi cacy was decreased and in 32.6% (15) patients, the airfl ow effi cacy increased. Dome splitting signifi cantly decreased the airfl ow effi cacy of the patients (P<0.05). Airfl ow effi cacy decreased (-7.19±23.7) in the left nostrils than right nostrils (-7.28±14.7). Airfl ow effi cacy of the patients signifi cantly decreased (P<0.05).These results suggested rhinoplasty surgery using dome splitting decreased the nasal airfl ow effi cacy after the surgery, hence care must be exercised for alterations in nasal air fl ow resistance when manipulating the nasal framework is done.