Floris V W J van Zijl, Anke W van der Eerden, Melania Stubos, Ronald Booij, Hilco P Theeuwes, Dimitris Rizopoulos, Frank R Datema
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引用次数: 0
Abstract
Background: Dorsal preservation is a recently popularized technique to lower the nasal dorsum without opening the cartilaginous vault. Improved nasal breathing has been reported after lowering an intact dorsum using preservation techniques, suggesting that septal deprojection opens the internal nasal valves. The goal of this study was to evaluate the effect of dorsal preservation on internal nasal valve dimensions in noses with an overprojected cartilaginous septum.
Methods: Ten postmortem human specimen heads with a tension nose deformity were imaged using ultra-high-resolution photon-counting detector computed tomography, after which a low-strip let-down technique was performed on each specimen. Following dorsal lowering, scans were repeated and internal nasal valve angle and area of pre- and postoperative scans were measured by three assessors. Differences in pre- and postoperative measurements were assessed using a linear mixed-effects model.
Results: A significant increase in both internal nasal valve angle (4.28 degrees, 95% CI: 3.11-5.46) and area (8.86 mm2, 95% CI: 7.11-10.61) was demonstrated after dorsal lowering. Interrater reliability among the three assessors was high, with ICCs ranging from 0.839 to 0.985.
Conclusions: This study provides morphological evidence that the internal nasal valve widens after mobilizing the dorsum and lowering the septum, without alterations to the cartilaginous vault itself. Although these results suggest that low-strip dorsal preservation may be effective in treating the functionally impaired tension nose, clinical studies are necessary to substantiate these findings in live tissue.
期刊介绍：
The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope.
• Broncho-esophagology
• Communicative disorders
• Head and neck surgery
• Plastic and reconstructive facial surgery
• Oncology
• Speech and hearing defects
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