Nasal valve obstruction: reconstruction of the upper lateral cartilage by using septal versus conchal cartilage graft

The nasal valve refers to the cross-sectional area bordered by the junction of the caudal portion of the upper lateral cartilage and the nasal septum. This study was planned to include patients suffering from nasal valve obstruction due to weakened or deformed upper lateral cartilage which may be associated with deviated septum or hypertrophied inferior turbinate. In these cases reconstruction of the upper lateral cartilage was done using various types of cartilage grafts [septal or conchal] through closed approach. This was accompanied by septoplasty or turbinoplasty when indicated. According to the type of cartilage graft used the cases were divided into two groups: The 1[st] group [l5 patients] had been operated using septal cartilage graft and the 2[nd] group [15 patients] by conchal cartilage graft. Patients were subjected to serial clinical examination, nasal endoscopy, photography and rhinomanometry. Results showed the use of septal cartilage graft is superior to conchal one in correction of nasal valve obstruction. This is due to: [1] Use of septal cartilage graft is usually associated with septoplasty so the airway becomes more patent due to correction of septal deviation and reconstruction of upper lateral cartilage, [2] The septal cartilage graft is stronger than the conchal cartilage graft so it gives more support for the upper lateral cartilage, [3] The incidence of complications is less with the use of septal cartilage graft [cartilage resorption, cartilage extrusion and visibility of the edges of cartilage]. We recommend the use of septal cartilage graft for reconstruction of the upper lateral cartilage in cases of nasal valve obstruction

Reduction rhinoplasty and nasal patency: acoustic rhinometric evaluation

Reduction rhinoplasty inherently decreases the cross-sectional area of the nasal airway unless surgical measures are taken to prevent this. Acoustic rhinometry is a non invasive and reliable objective method for determining the cross-sectional areas of the nasal cavity, this report describes the findings in a group of 20 patients suffering from nasal deformity who under went hump removal and lateral and medial osteotomies. Tipplasty was performed either by the cartilage splitting technique or by delivery of alar cartilages. Acoustic rhinometry was performed pre and at 6 months post-rhinoplasty. From the study we recommended preoperatire measurement of cross-sectional areas of nasal cavity to determine at risk patients for developing nasal obstruction and site of it, secondly certain surgical measures should be taken during reduction rhinoplasty for prevention of nasal obstruction as correction of internal nasal valve incompetence using cartilage graft, outfracture and turbinoplasty