The Effect on Snoring of Structural Nasal Valve Dilatation With a Butterfly Graft

Abstract

To evaluate the effect on snoring of structural nasal valve dilatation with butterfly spreader grafts in patients with nasal valve insufficiency. Design: Retrospective medical chart review and telephone follow-up; mean ± SD follow-up time, 20.7±11.34 months (range, 3-48 months). Settings: Tertiary care referral center. Subjects: A total of 37 snoring patients with nasal valve insufficiency who underwent nasal valve dilatation with a butterfly spreader graft. Interventions: The conchal cartilage butterfly graft technique was performed during rhinoplasty through either an external or endonasal approach. Main Outcome Measure: To establish through a retrospective review that butterfly graft conchal cartilage nasal reconstruction is effective in reducing snoring. Results: After surgery, 30 patients (81%) had significant improvement in breathing, 5 (14%) had slight improvement, and 2 (5%) had no benefit in breathing. Snoring stopped completely in 11 (30%) of the patients after surgery. The improvement in snoring was significant in 13 patients (35%) and slight in 3 (8%). Twenty-six patients (70%) reported tiredness and grogginess on awakening before the surgery. Surgery significantly improved patients' tiredness and grogginess on awakening in 15 cases (58%), slightly improved them in 5 (19%), and did not change the patients' tiredness and grogginess in 6 cases (23%). Conclusion: The conchal cartilage butterfly graft yields successful results not only in breathing but also in snoring symptoms in patients with nasal valve insufficiency.

Evolution of the butterfly graft technique: 15‐year review of 500 cases with expanding indications

“…To our knowledge, this study represents the largest group of patients undergoing the butterfly graft reported in the medical literature. Our findings confirm the previously reported efficacy of the butterfly graft in relief of NAO in both primary and secondary rhinoplasty patients . Although not the focus of this study, in addition to contributing to a general sense of well‐being, patients frequently report dramatic improvement in exercise tolerance and sleep hygiene.…”

“…Numerous studies have shown improvement in snoring, sleep hygiene, continuous positive airway pressure (CPAP), and CPAP tolerance with the use of ENDs. Our patients frequently report similar improvement in these sleep‐related issues, consistent with previously reported improvement in snoring and in patients’ perceived tiredness and grogginess on awakening following the butterfly graft …”

“…Our patients frequently report similar improvement in these sleep-related issues, consistent with previously reported improvement in snoring and in patients' perceived tiredness and grogginess on awakening following the butterfly graft. 16 This study demonstrates the efficacy of the butterfly graft in relieving patient-perceived NAO. The power of the butterfly graft to achieve this is due to its close resemblance of the natural anatomy of the middle nasal vault, and also its use of the dorsal septum as a fulcrum, which creates a significant mechanical advantage in stabilizing the nasal sidewall.…”

“…These technical changes have allowed for an expansion in the utilization of butterfly graft to a broader group of patients, who would not have otherwise had the opportunity for the superlative functional results implicit with the butterfly graft. [13][14][15][16][17][18] Despite extending patient selection, our results show that the patient-reported aesthetic results remain favorable, and the functional outcomes remain constant.…”

Iatrogenic collapse of the nasal valve after aesthetic rhinoplasty

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