Fung Elaine, Hong Paul, Moore Corey, Taylor S Mark
Department of Surgery, Dalhousie University, 5850 University Avenue, Halifax, NS, Canada B3H 2Y9 ; Department of Surgery, IWK Health Centre, 5850/5920 University Avenue, P.O. Box 9700, Halifax, NS, Canada B3K 6R8.
Department of Otolaryngology-Head and Neck Surgery, University of Western Ontario, London, ON, Canada N6B 2P2.
Plast Surg Int. 2014;2014:618313. doi: 10.1155/2014/618313. Epub 2014 Aug 25.
Objective. To assess the outcomes of functional rhinoplasty for nasal valve incompetence and to evaluate an in-office test used to select appropriate surgical techniques. Methods. Patients with nasal obstruction due to nasal valve incompetence were enrolled. The modified Cottle maneuver was used to assess the internal and external nasal valves to help select the appropriate surgical method. The rhinoplasty outcomes evaluation (ROE) form and a 10-point visual analog scale (VAS) of nasal breathing were used to compare preoperative and postoperative symptoms. Results. Forty-nine patients underwent functional rhinoplasty evaluation. Of those, 35 isolated batten or spreader grafts were inserted without additional procedures. Overall mean ROE score increased significantly (P < 0.0001) from 41.9 ± 2.4 to 81.7 ± 2.5 after surgery. Subjective improvement in nasal breathing was also observed with the VAS (mean improvement of 4.5 (95% CI 3.8-5.2) from baseline (P = 0.000)). Spearman rank correlation between predicted outcomes using the modified Cottle maneuver and postoperative outcomes was strong for the internal nasal valve (Rho = 0.80; P = 0.0029) and moderate for the external nasal valve (Rho = 0.50; P = 0.013). Conclusion. Functional rhinoplasty improved subjective nasal airflow in our population. The modified Cottle maneuver was effective in predicting positive surgical outcomes.
目的。评估功能性鼻整形术治疗鼻瓣膜功能不全的效果，并评估一种用于选择合适手术技术的门诊检查方法。方法。纳入因鼻瓣膜功能不全导致鼻塞的患者。采用改良科特尔手法评估鼻内瓣膜和鼻外瓣膜，以帮助选择合适的手术方法。使用鼻整形术效果评估（ROE）表格和10分制鼻呼吸视觉模拟量表（VAS）比较术前和术后症状。结果。49例患者接受了功能性鼻整形术评估。其中，35例单纯植入了鼻撑条或鼻扩张移植物，未进行其他手术。术后总体平均ROE评分从41.9±2.4显著提高至81.7±2.5（P<0.0001）。VAS评分也显示鼻呼吸主观改善（与基线相比平均改善4.5（95%可信区间3.8 - 5.2），P = 0.000）。改良科特尔手法预测的结果与术后结果之间，鼻内瓣膜的斯皮尔曼等级相关性较强（Rho = 0.80；P = 0.0029），鼻外瓣膜的相关性中等（Rho = 0.50；P = 0.013）。结论。功能性鼻整形术改善了我们研究人群的主观鼻气流。改良科特尔手法能有效预测手术的积极效果。
