الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 155 |  |  |
| | | from | 155 | | |
Abstract
Surgical management of a rhinoplasty case should address both aesthetic and functional aspects, and for optimal results rhinoplasty surgeon should be aware of the external and internal nasal anatomy, nasal esthetic dimensions, physiology and pathophysiology of the nose.
The key structures which might cause nasal airway obstruction are the external nasal valve, nasal septum, inferior turbinate and the internal nasal valve, and the later form the most of the upper airway resistance.
Many techniques have been described to preserve or treat a collapsed internal nasal valve such as Spreader Graft, Spreader Flaps, Nasal valve flaring sutures, and different types of horizontal mattress sutures.
Many types of investigations have been designed to evaluate nasal obstruction and collapsed internal nasal valve; some are subjective as VAS, NOSE, Cottle’s and Modified Cottle’s test. Others are objective as Rhinomanometry, Acoustic Rhinometry and Computed Topography.
Between 2017 and 2018, 20 cases complaining of nasal obstruction beside the aesthetic complaints were included in the study, in a nonrandomized fashion Spreader Graft was used in 11 patients (group A) and Spreader Flap was used in 9 patients (group B) after intraoperative assessment of the upper lateral cartilages.
All patients have been subjected pre and postoperatively to Cottle’s test and a simple grading system for nasal airway obstruction as a subjective method, and Axial CT scan to measure the internal nasal valve surface area as an objective method.
At a mean follow up period of 10.2 months, group A and group B patients showed significant increase in the nasal valve area measured by the axial CT, and these results have correlated well with the significant improvement in the cottle’s test and the airway breathing questionnaire results postoperatively.
Although there was no significant difference between the two groups result, concluding that both Spreader Graft and Spreader Flap techniques are effective ways in treating internal nasal valve collapse and nasal obstruction.
We concluded in our study that there is no statistically significant difference between both types of techniques regarding the results of the postoperative CT and subsidence of the subjective symptoms and signs of the patients, whereas both techniques have significantly proved radiological and clinical progression with a good correlation between subjective and objective tests.