Nasal valve surgery

The nasal valve region plays a key role in nasal breathing. In the international literature, a variety of techniques have been described to rectify nasal valve compromise, but based on the present evidence it is impossible to counsel a patient as to which technique is most effective. The aim of this study was to evaluate the results of surgery of the nasal valve through a hemitransfixion incision objectively with nasal endoscopy and rhinomanometry. The study group consisted of 54 males and 15 females with a mean age of 41.8 ± 14.4 years, (range: 21-72 years). After a mean follow-up of 8 ± 4.1 months, nasal endoscopy demonstrated the favourable effects of surgical treatment with a normalization of the nasal valve angles. Only 5 patients showed persistent nasal valve stenosis, and were scheduled for revision surgery. Preoperatively, total decongested inspiratory NARs were 0.245 ± 0.091 Pa/cm3/s and decreased significantly after the operation (p < 0.0005) to 0.154 ± 0.059 Pa/cm3/s. Similarly, preoperatively total decongested expiratory NARs were 0.188 ± 0.068 Pa/cm3/s and decreased significantly after the operation (p < 0.0005) to 0.142 ± 0.059 Pa/cm3/s. Moreover, total dilated inspiratory and expiratory NARs resulted significantly (p < 0.0005) lower than the preoperatively total decongested NARs, with a mean value of 0.120 ± 0.059 Pa/cm3/s and 0.102 ± 0.057 Pa/cm3/s, respectively. Statistical analysis did not reveal any influence of sex and age in rhinomanometric measurements. Hemitransfixion incision allowed a wide access to the whole valve area for inspection and correction of the various components. Rhinomanometry, performed in a decongested condition and after dilation test, was thus a useful diagnostic tool for the preoperative diagnosis of nasal valve obstruction and permitted to assess quantitatively the favourable effect of surgical procedures.