The Effects of Alar Batten Grafts on Nasal Airway Obstruction and Nasal Steroid Use in Patients With Nasal Valve Collapse and Nasal Allergic Symptoms

Sufyan, Ahmed S.; Hrisomalos, Emily N.; Kokoska, Mimi S.; Shipchandler, Taha Z.

doi:10.1001/jamafacial.2013.974

Cited by 13 publications

(6 citation statements)

References 18 publications

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“…This scale now serves as a well-accepted tool to assess postoperative nasal obstruction. 13,14 In our study, the results of the NOSE questionnaire demonstrated statistically significant improvement in all 5 categories when absorbable plates were used to secure CSEGs. From a functional standpoint, these results suggest that absorbable plates can be used in septorhinoplasty to secure CSEGs without leading to obstruction.…”

Section: Discussionsupporting

confidence: 51%

“…For the NOSE questionnaires, we compared preoperative scores vs postoperative scores to assess for nasal airway obstruction similar to other published studies. 13,14 Unique to our study, the NOSE score results were isolated by question (Q) (Q1, congestion; Q2, blockage or obstruction; Q3, breathing through nose; Q4, trouble sleeping; Q5, breathing during exercise). All patients filled out the NOSE questionnaire preoperatively, as well as at all routine follow-up visits.…”

Section: Study Parametersmentioning

confidence: 99%

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The Effect of Polydioxanone Absorbable Plates in Septorhinoplasty for Stabilizing Caudal Septal Extension Grafts

Caughlin

Been

Rashan

et al. 2015

JAMA Facial Plast Surg

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IMPORTANCE Caudal septal extension grafts (CSEGs) can be used to alter and secure nasal projection and length. Graft position and thickness play an important role in terms of both function and aesthetics. The limitations of harvesting cartilage from additional sites necessitate development of a more efficient method for securing CSEGs. OBJECTIVE To assess the efficacy and safety of polydioxanone absorbable plates used in primary and revision septorhinoplasty. DESIGN, SETTING, AND PARTICIPANTS We investigated all patients who underwent primary or revision septorhinoplasty with the use of absorbable plates to secure CSEGs at a tertiary academic medical center from 2010 to 2014. To standardize and objectify the symptoms of nasal obstruction, a validated quality-of-life instrument called the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire, with 5 questions on a scale of 0 to 4, was implemented preoperatively and postoperatively. Preoperative and multiple successive postoperative measurements of nasal length and projection were taken using 3dMDvultus imaging software. MAIN OUTCOMES AND MEASURES Change in NOSE questionnaire score, change in nasal length and projection, and complications. RESULTS There were no absorbable plate-related complications in the 95 included patients. Comparing preoperative and postoperative NOSE questionnaire scores, there was a statistically significant improvement in all 5 categories: mean (SD) change of −1.42 (1.59) in congestion, −1.56 (1.53) in blockage or obstruction, −1.60 (1.54) in breathing through nose, −0.90 (1.54) in trouble sleeping, and −1.28 (1.46) in breathing during exercise (P < .001 for all) in the 50 patients with available data. In the 24 patients with greater than 180 days of follow-up, follow-up ranged from 183 to 717 days, and mean (SD) change in nasal length and projection was 0.64 (2.19) and 0.26 (0.96) mm, respectively, showing no statistically significant change over time (P = .17 and .21, respectively). CONCLUSIONS AND RELEVANCE In our study population, nasal length and projection maintained position over time when absorbable plates were used to secure CSEGs. Absorbable plates appear safe and effective when used to secure CSEGs and limit the requirement of harvesting additional cartilage. Nasal airway improvement can be obtained when absorbable plates are used to secure CSEGs. LEVEL OF EVIDENCE 4.

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Section: Discussionsupporting

confidence: 51%

Section: Study Parametersmentioning

confidence: 99%

The Effect of Polydioxanone Absorbable Plates in Septorhinoplasty for Stabilizing Caudal Septal Extension Grafts

Caughlin

Been

Rashan

et al. 2015

JAMA Facial Plast Surg

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“…Cervelli et al [31] reported that all patients in his study had improvement in nasal breathing for both internal and external valve collapse. In two separate studies, Sufyan and Shipchandler et al [29,32] noted improvement in nasal breathing with batten grafts and also decreased usage of nasal steroids. The latter possibly due to less need for steroids as a result of larger nasal passageways.…”

Section: Alar Batten Graftsmentioning

confidence: 99%

Update on the evidence for functional rhinoplasty techniques

Chan

Shipchandler

2015

Current Opinion in Otolaryngology & Head and Neck Surgery

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Purpose of reviewFunctional rhinoplasty is a term that is commonly used to describe any technique used to address nasal obstruction in the nasal valve region. Etiology of nasal valve collapse differs based on the site. Internal valve collapse may be idiopathic or associated with previous rhinoplasty, trauma, or weakened cartilage in older patients. External valve collapse is usually idiopathic and less likely to be associated with previous surgery. Various techniques have been developed over time, and the data in support of functional rhinoplasty continues to increase. Recent findingsThis article discusses popular techniques currently in use as well as newer techniques that have been described over the past several years. In addition, there is a trend toward utilizing objective testing and validated assessment scales to assess post-operative changes. SummaryFunctional rhinoplasty utilizes a multitude of techniques to address nasal valve collapse. While high-level data is lacking, the current literature is in support of nasal valve correction to improve nasal breathing. Most importantly, the technique employed is unique for each patient.

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“…It may be used on one side or bilaterally according to specific needs and indications. [20,22] 2. Lateral crural strut graft: Unlike batten grafts the lateral crural strut graft is placed beneath the lower lateral cartilages, so after adequate injection of local anesthetic under the lower lateral cartilages, the lateral crura is precisely stripped off from its underlying skin and a quadrangular piece of cartilage is fixed under the lateral crura.…”

Section: Weak Lower Lateral Cartilages and Pinch Deformitymentioning

confidence: 99%

Advanced Rhinoplasty: Problems and Solutions

Varedi¹

2015

A Textbook of Advanced Oral and Maxillofacial Surgery Volume 2

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A tip spanning suture is a mattress suture that is used on each dome area to refine the angle between lateral crura and medial crura cartilages (Figure 1).This suture has been shown to increase tip projection. 2. Cap graft: Cap graft is a small piece of cartilage that is precisely formed and trimmed and fixed over the cartilaginous tip (Figure 2). The main indication of this graft is necessity to form and refine the tip; though this graft slightly increases tip projection in this technique. 3. Shield graft (Sheen graft): The shield graft is the only technique that may arbitrarily add to tip projection. A usual approach is to prepare and fix a bigger piece of cartilage. This

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The Effects of Alar Batten Grafts on Nasal Airway Obstruction and Nasal Steroid Use in Patients With Nasal Valve Collapse and Nasal Allergic Symptoms

Cited by 13 publications

References 18 publications

The Effect of Polydioxanone Absorbable Plates in Septorhinoplasty for Stabilizing Caudal Septal Extension Grafts

The Effect of Polydioxanone Absorbable Plates in Septorhinoplasty for Stabilizing Caudal Septal Extension Grafts

Update on the evidence for functional rhinoplasty techniques

Advanced Rhinoplasty: Problems and Solutions

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