Surgery of the Nasal Valve Scott B. Roofe, MD, FACS Facial Plastic - PDF document

Surgery of the Nasal Valve Scott B. Roofe, MD, FACS Facial Plastic and Reconstructive Surgery Tripler Army Medical Center

From: Nasal Valve Reconstruction: � Experience in 53 Consecutive Patients Nasal surgery Internal valve Arch Facial Plast Surg. 2004;6(3):167-171. doi:10.1001/archfaci.6.3.167 Internal Nasal Valve 10-15 degrees

From: Nasal Valve Reconstruction: � Experience in 53 Consecutive Patients Arch Facial Plast Surg. 2004;6(3):167-171. doi:10.1001/archfaci.6.3.167

Evaluation

Nasal Obstruction and Septoplasty Effectiveness Scale Physician AAO-HNS#:____________Patient ID: __________________ Today’s date: __ __/__ __/__ __ __ __ � To the Patient: Please help us to better understand the impact of nasal obstruction on your quality of life by completing following survey . Thank You! Over the past ONE month, how much of a problem were the following conditions for you? Please circle the most correct response Not a Very Mild Moderate Fairly Bad Severe Problem Problem problem Problem problem 1. Nasal congestion or stuffiness 0 1 2 3 4 2. Nasal blockage or obstruction 0 1 2 3 4 3. Trouble breathing through my nose 0 1 2 3 4 4. Trouble sleeping 0 1 2 3 4 5. Unable to get enough air through my 0 1 2 3 4 nose during exercise or exertion NOSE Scale

TECHNIQUES SPREADER GRAFTS LATERAL FLARING SUTURE AUTO-SPREADER ALAR BATTEN GRAFTS NASAL VALVE SUSPENSION The Nasal Valve Dilemma The Narrow Straw vs the Weak Wall ARCH FACIAL PLAST SURG/VOL 14 (NO. 1), JAN/FEB 2012 WWW.ARCHFACIAL.COM

Spreader Grafts

Intranasal Placement From: Endonasal placement of spreader grafts: experience in 41 consecutive patients. Arch Facial Plast Surg. 2012 Sep-Oct;14(5):318-22. doi: 10.1001/ archfacial.2012.173. From: Surgery for the Dysfunctional Nasal Valve: � Cadaveric Analysis and Clinical Outcomes Arch Facial Plast Surg. 1999;1(2):105-110. doi:10.1001/archfaci.1.2.105 Lateral Flaring Suture

From: Surgery for the Dysfunctional Nasal Valve: � Cadaveric Analysis and Clinical Outcomes Arch Facial Plast Surg. 1999;1(2):105-110. doi:10.1001/archfaci.1.2.105 Lateral Flaring Suture Autospreader From: Nasal Airway Preservation Using the Autospreader Technique: � Analysis of Outcomes Using a Disease-Speci � c Quality-of-Life Instrument Arch Facial Plast Surg. 2011;13(4):231-233.

From: Nasal Airway Preservation Using the Autospreader Technique: � Analysis of Outcomes Using a Disease-Speci � c re re re re re rese se s rvatio se se i n Using the Autospreader Technique: Analysis of Outcom s es U i si si si si si sin i Quality-of-Life Instrument Arch Facial Plast Surg. 2011;13(4):231-233. doi:10.1001/archfacial.2011.7

Batten Alar Batten Graft From: Surgery for the Dysfunctional Nasal Valve: � Cadaveric Analysis and Clinical Outcomes Arch Facial Plast Surg. 1999;1(2):105-110. doi:10.1001/archfaci.1.2.105

From: Nasal Batten Grafts: � Are Patients Satis � ed? Arch Facial Plast Surg. 2012;14(1):14-19. doi:10.1001/archfacial.2011.1187 Alloplastic Implants

Nasal Valve Suspension . . From: Placement of a Lateral Nasal Suspension Suture Via an External Rhinoplasty Approach Arch Facial Plast Surg. 2007;9(3):214-216. doi:10.1001/archfaci.9.3.214

From: Placement of a Lateral Nasal Suspension Suture Via an External Rhinoplasty Approach Fr Fr Fr Fr Fr Fr Fr Fr F om r r om o om om m m m : Pl Pl Pl Pl Pl Pl P l ac a ac ac c c em em e em em m m en en e t n n of o a Lat of of of of f at at a er t t er e al r a Nas al l a al as al a S s u pe pe pe pe pe pe pe pe pe pe p ns pe pe pe pe pe pe pe pe pe e e e e e e e e e ns n ns ns ns ns ns ns ns ns ns ns ns ns ns ns ns ns ns ns s s s s io i n io io io io io io io io io io io io io io o o o o o o o n n Su S tu Su Su u tu ture re re re re re re re re re re re re re r re re re re re re re re re re e e e e e e e e e e e e e e e e V a ia ia ia ia i a a an n Ex n Ex Ex Ex Ex Ex E te x te te te te t rn e rn r al rn n n al al al a Rhi l hi hi hi h no no n pl no no no no no no no o pl pl pl p as pl as as a ty s s t App ty ty ty ty y pp pp pp p ro p p r ac ro ro o ac ac ac a h c Arc A Ar Arc Arc Arc Arch Facial Plast Surg. 2007;9(3):214-216. doi:10.1001/archfaci.9.3.214 Arc Arc Arc Arc h F h h F h F h F h F h F F F F a al aci ac ac ac ci c al al Pla P st Pla Pla a a st st st s Sur t Sur Sur Sur Surg. Sur ur r r g. g. g 20 2 20 0 00 0 00 00 00 00 00 00 0 0 0 0 0 0 7;9 7;9 7;9 7;9 7;9 7;9 7;9 7;9 7;9 7;9 7;9 7;9 7;9 7;9 7 7;9 7;9 7;9 ;9 ;9 ;9 ;9 ;9 ;9 ;9 ;9 ;9 ;9 ; ;9 9 9 9 9 9 9 (3) ( (3 (3 (3 (3) (3) (3) (3) (3) (3) (3) (3) (3) (3) (3) (3) 3) 3) 3) 3 3 ) : :2 :21 :21 :2 :2 :21 :2 :2 21 2 21 21 21 21 21 21 21 21 21 21 21 1 4 -2 2 16 16 16 16 16 16 16 16 16 16 16 16 16 16. 16 16 16. 1 16. 16. 16 16 16 16. 16 16. 16 16 16 6 6 6 6 6 6 6 6 6. 6 6 6 . . . . do d do do do do do do do do do do do o i i: i: i: : :1 : : 1 1 0.1 0.1 0 0.1 . 001 00 00 /ar 01 01 01 0 1 /ar /a chf /ar /ar /ar a r r chf chf chf chf ch c ac a .9. ac ac ac ci ci ci ci c i i .9. .9. .9 9 3. 3 3.2 3. 3. .2 2 2 14 14 14 14 1 4 4

Nasal Valve Suspension • Before and after……………….. • Before and after……………….. Nasal Valve Suspension

From: Intraoperative Suction-Assisted Evaluation of the Nasal Valve in Rhinoplasty Arch Facial Plast Surg. 2012;14(1):34-38. doi:10.1001/archfacial.2011.1111

CONCLUSION • LOCALIZE • SUPPORT • WIDEN • TURBINATES AND SEPTUM