Functional and esthetic outcomes of functional rhinoplasty for internal nasal valve dysfunction in Asian patients

Hahn Jin Jung; Min Woo Park; Woo Sub Shim; Jee Hye Wee

doi:10.1016/j.bjorl.2024.101430

Functional and esthetic outcomes of functional rhinoplasty for internal nasal valve dysfunction in Asian patients

Braz J Otorhinolaryngol. 2024 Apr 3;90(4):101430. doi: 10.1016/j.bjorl.2024.101430. Online ahead of print.

Authors

Hahn Jin Jung¹, Min Woo Park², Woo Sub Shim¹, Jee Hye Wee³

Affiliations

¹ Chungbuk National University College of Medicine, Chungbuk National University Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Cheongju, South Korea.
² Kangdong Sacred Heart Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Seoul, South Korea.
³ Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Anyang, South Korea. Electronic address: weejh07@hallym.or.kr.

Abstract

Objective: This study aimed to use validated measures to evaluate the functional and esthetic outcomes in patients who underwent functional rhinoplasty for Internal Nasal Valve Dysfunction (INVD) in Korea.

Methods: A retrospective review of consecutive patients who underwent functional rhinoplasty for INVD confirmed by endoscopic findings and the modified Cottle test between 2016 and 2018 was performed. Nasal obstruction was assessed with the Visual Analog Scale (VAS) and nasal obstruction symptom evaluation (NOSE) scale. Acoustic rhinometry was performed pre- and post-operatively. The Minimal Cross-Sectional Area (MCA) of the nose was measured. Objective assessment of the esthetic outcomes was performed with the Objective Rhinoplasty Outcome Score (OROS), which assesses tip rotation, projection, width, dorsal height, width, length, symmetry, and the overall result.

Results: Fifty-seven patients (46 men and 11 women; mean age, 30.5 ± 12.3 years) who underwent functional rhinoplasty were included in this study. The VAS and NOSE scores indicated functional improvement in all cases (all p < 0.001). There were no significant between-group differences (VAS score, p = 0.274; NOSE score, p = 0.952). The objective functional outcomes evaluated using MCA on the concave (p = 0.478) and convex (p = 0.631) sides did not differ significantly pre- and post-operatively. The subjective evaluation of esthetic satisfaction revealed no between-group difference. Moreover, 31 out of 44 patients (70.5%) with static INVD and nine out of 14 patients (64.3%) with dynamic or combined INVD showed excellent outcomes. Regarding objective esthetic outcomes, scores for the eight factors were >3, and there was no significant difference between the two groups (all p > 0.05).

Conclusions: Functional rhinoplasty, including extracorporeal septoplasty and spreader grafting, may be a viable option for correcting INVD with functional and esthetic improvement. Dynamic INVD is less prevalent among Asians, and there was no significant difference in the surgical outcomes compared with those of static INVD.

Level of evidence: Level 4.

Keywords: Nasal obstruction; Nasal septum; Rhinoplasty.