engleski

Intranasal flaring suture: A novel approach to dysfunctional nasal valve repair

Nasal obstruction can be a result of internal and/or external valve dysfunction. A deviated nasal septum, inferomedially displaced upper lateral cartilages (ULC), narrowed pyriform aperture, scarring at the intercartilaginous junction and inferior turbinate hypertrophy can be reasons of internal valve problems. Flare sutures are used in an open approach especially coupled with spreader grafts to widen the internal nasal valve angle (INV). Patients with breathing problems, anatomically normal nasal valves showing inspiratory collapse and a positive modified Cottle maneuver are ideal for this type of surgery. The authors suggest placing a clear non-resorbable mattress suture from the lateral to the contralateral ULC over the septum like a fulcrum. Nasal valve reconstruction is performed through an intranasal approach with incisions that expose the caudal and lateral part of ULC. This type of suture pulls both ULCs dorsally and widens the INV with significant improvement in breathing (improved NOSE scale score).

Nasal obstruction ; reconstruction ; flare suture

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