The Relative Importance of Septal and Nasal Valvular Surgery in Correcting Airway Obstruction in Primary and Secondary Rhinoplasty

摘要: Despite the apparent association of nasal airway obstruction with septal deviation and/or inferior turbinate hypertrophy, increasing clinical evidence suggests that incompetence internal or external valves may also affect airflow. But how much? What is relative importance and septum in causing obstruction? One-hundred sixty consecutive patients (88 primary rhinoplasty, 72 secondary rhinoplasty) without hypertrophy perforation operated on for correctable were evaluated prospectively by anterior active mask rhinomanometry preoperatively from 1 to 43 months (mean 8.4 months) postoperatively after 1% phenylephrine decongestion eliminate mucosal factors. Patients stratified according site(s) preoperative at valves, septum, any combination three. Geometric mean airflow was calculated independent measurements each airway. Surgical treatment consisted submucous resection, valvular reconstruction dorsal spreader grafts, cartilage bone grafts; turbinectomy not performed. All procedures performed endonasally. In entire 160 patient study group, surgery corrected 152 (95 percent); 8 had partial residual obstruction. Our data support prior rhinologic showing only a modest (and statistically insignificant, p < 0.4, n = 25) improvement (geometric) following alone. However, alone increased 2.6 times over values (n 10). Internal grafts 17) 29) 2.0 times; equally effective supporting valves. The largest postoperative seen plus 21), which flow 4.9 (p 0.0003). whom experienced as much corrected. Finally, 54 rhinoplasty who previously undergone septoplasty 49 (91 percent). Notably, 110 (69 percent) lateralized obstruction; however, deviated toward clinically obstructed side 51 these (46 other percent, subjectively contralateral deviated. Nasal function should be assessed all many individuals, effects equal surpass cause