Division of Plastic and Reconstructive Surgery, Stanford University, CA, USA.
Aesthetic Plast Surg. 2011 Apr;35(2):211-5. doi: 10.1007/s00266-010-9589-4. Epub 2010 Nov 17.
A normal-appearing upper lateral cartilage (ULC) or lower lateral cartilage (LLC) may be functionally abnormal. The Cottle sign estimates obstruction but not its exact location. A test is needed that evaluates the ULC and LLC separately.
The study included 30 patients with airway obstruction symptoms and signs referable only to the nasal valves. They received a Cottle test and a Breathe-Rite nasal strip to the middle third of the nose and again to the lower third (the rims). The patients were asked whether the strip made their inspiration better, worse, or no different and classified as BR 0 (no airway obstruction due to ULC/LLC dysfunction), BR I (improvement with the strip on the ULC), BR II (improvement with the strip on the LLC), or BR III (improvement with strips on both the ULC and the LLC, independently). All the patients underwent surgery involving spreader grafts, lateral crural struts, suture techniques, and the like. Correlations were sought between the BR classification, Cottle sign, and physical integrity of the ULC/LLC.
A total of 12 patients required internal valve correction, whereas 8 required external valve correction, and 10 required correction of both. The Cottle test was nonspecific because most patients in all the groups exhibited a positive Cottle. However, the BR classification was specific, correlating with functional outcomes for 27 of the 30 patients. The McNemar test showed a significant correlation (Χ(2) = 9.09091; P = 0.00257) between physical finding and BR score.
Inspiratory nasal function (related to ULC/LLC cartilages) is easily classified using nasal strips. The BR test is more specific and powerful than the Cottle test.
外观正常的上外侧软骨（ULC）或下外侧软骨（LLC）可能功能异常。Cottle 征估计存在阻塞，但不能确定其确切位置。需要一种可以分别评估 ULC 和 LLC 的测试。
该研究纳入了 30 例气道阻塞症状和体征仅累及鼻阀的患者。他们接受了 Cottle 测试和 Breathe-Rite 鼻贴，分别贴于鼻中段和下段（鼻翼）。患者被问及鼻贴是否改善了他们的吸气，并将其分为 BR 0 （无 ULC/LLC 功能障碍导致的气道阻塞）、BR I （ULC 侧鼻贴改善）、BR II （LLC 侧鼻贴改善）或 BR III （ULC 和 LLC 双侧鼻贴均改善）。所有患者均接受了涉及鼻中隔扩展移植物、外侧穹隆支撑物、缝合技术等的手术。寻找 BR 分类、Cottle 征和 ULC/LLC 解剖完整性之间的相关性。
共 12 例患者需要进行内部瓣膜矫正，8 例需要进行外部瓣膜矫正，10 例需要同时进行内外侧瓣膜矫正。Cottle 征不具有特异性，因为所有组的大多数患者均表现出阳性 Cottle 征。然而，BR 分类具有特异性，与 30 例患者中的 27 例的功能结果相关。McNemar 检验显示体格检查与 BR 评分之间存在显著相关性（Χ(2) = 9.09091；P = 0.00257）。
使用鼻贴可以轻松对吸气性鼻功能（与 ULC/LLC 软骨有关）进行分类。BR 试验比 Cottle 试验更具特异性和有效性。
