Spreader graft to correct nasal valve stenosis with high septal deviation

Spreader graft to correct nasal valve stenosis with high septal deviation. Objectives: Internal nasal valve stenosis can increase nasal airway resistance and cause nasal obstruction. This study investigated the relationship between different types of internal nasal valves and nasal obstruction, and the effect of spreader graft insertion on nasal obstruction among patients with stenosis of different types of internal nasal valves.

Methodology: Thirty-two patients (64 internal nasal valves) with symptoms of nasal obstruction were recruited consecutively from November 2012 to July 2016 at Taipei and Sijhih Cathay General Hospitals. The internal nasal valves were classified into six types according to endoscopic findings. The severity of nasal obstruction and effect of the modified Cottle maneuver were recorded using a visual analogue scale (VAS). Differences in the severity of nasal obstruction among patient with the different types of internal nasal valves were analyzed. The severity of nasal obstruction and effect of the modified Cottle maneuver were compared before and after spreader graft insertion.

Results: The most common type of internal nasal valve was high septal deviation (N=24, 39%), which also caused the most severe nasal obstruction (VAS score 6.42). The severity of nasal obstruction and effect of the modified Cottle maneuver decreased significantly after spreader graft insertion (average VAS scores decreased from 5.4 to 1.5 and 3 to 0.6, respectively).

Conclusions: In our Taiwanese patients with nasal obstruction caused by internal nasal valve stenosis, the most common type of internal nasal valve was high septal deviation. Spreader graft insertion improved nasal obstruction in patients with all types of internal nasal valves.