Functional rhinoplasty with batten and spreader grafts for correction of internal nasal valve incompetence.

OBJECTIVE We a describe technique for correction of internal nasal valve incompetence (INVI) using functional rhinoplasty (FRP) with combined cartilaginous batten and spreader grafts and report the functional and cosmetic outcomes. DESIGN Prospective series using subjective improvement in nasal airway and quality of life. SETTING Subregional ENT centre, one operating rhinologist. PARTICIPANTS Twenty-three consecutive adults presenting to ENT department at North Hertfordshire NHS Trust with symptomatic INVI. MAIN OUTCOMES MEASURES Pre and post-operative symptom scores for nasal obstruction and its impact on overall quality of life using visual analogue scales (1-100mm). Cosmetic outcome graded using subjective scores. Statistical analysis performed using the Wilcoxon signed rank test. RESULTS We found a median subjective improvement on the visual analogue scale of 55 mm for nasal patency (p<0.001) and of 49 mm for quality of life (p<0.001). Twenty-two patients felt that the appearance of their nose had not changed or had significantly improved post operatively. CONCLUSION Combined use of batten and spreader grafts for the correction of INVI in normal or narrow nasal vaults is effective without compromising cosmesis.