A novel method for internal nasal valve reconstruction: H-graft technique

Abstract

Objectives: The aim of this study was to determine the efficacy of a novel method for internal nasal valve reconstruction that enables lateralization of the superior segment of upper lateral cartilages (ULC) from the septum to a greater extent than the spreader graft method with lateral wall support. Study Design: Prospective, controlled study set at a tertiary medical center. Methods: The study group was composed of 19 consecutive patients with pure internal nasal valve dysfunction who underwent surgery with the presented technique. All patients completed the Nasal Obstruction Symptom Evaluation (NOSE) and Rhinoplasty Outcomes Evaluation (ROE) tests preoperatively and at 12th month postoperative control to compare functional and aesthetic outcomes. Results: Based upon pre- and postoperative calculations made using NOSE scores, there was significant improvement regarding nasal blockage or congestion, troubled breathing and sleeping, and air through nose during exercise, respectively (P <.05). There were no aesthetic changes encountered by the patient when pre- and postoperative ROE scores were compared (P >.05). Conclusions: The H shape of the graft not only improves the graft stability on dorsal septum but also has the advantage of combining the spreader and the splay effects. Current data from this prospective study suggest that this technique may be used in the surgical treatment of internal nasal valve dysfunction. © 2010 The American Laryngological, Rhinological, and Otological Society, Inc.