Endonasal repositioning of the upper lateral cartilage and the internal nasal valve.

OBJECTIVES

Collapse of the upper lateral cartilage (ULC) is associated with narrowing of the internal nasal valve (INV). The goal of this article is to describe a novel procedure that repositions the ULC, opening the INV, without implants, grafts, or permanent sutures.

METHODS

Before-and-after digital photographs of patients with ULC and INV collapse who underwent endonasal ULC repositioning were analyzed. The surgical procedure consists of an intercartilaginous incision and the creation of a surface that permits scarification upon cartilage reapproximation. Precise placement of a support apparatus permits the ULC to heal into a position in direct contact with the lower lateral cartilage,thus dilating the INV. The percentage of collapse of the ULC (PCULC), determined by ULC shape measurements made with computer-aided design software, was compared on before-and-after photographs by use of Student's t-test (paired).

RESULTS

The study included 52 patients (79 procedures) followed for 1 to 18 months after surgery in the period 2007 to 2009. There were no complications or revision surgeries. The preoperative mean PCULC was 58.6%. The postoperative mean PCULC was 5.7% (p < 0.0001).

CONCLUSIONS

Repair of the INV via ULC repositioning is a simple, relatively safe procedure that produces a statistically significant improvement in the PCULC. The functional change at the INV may be inferred from the ULC shape, but further prospective clinical studies are required.