Functional nasal surgery.

Functional nasal surgery is designed to repair nasal obstruction frequently caused by previous reduction rhinoplasty or blunt nasal trauma. Distinguishing the statically narrowed nasal valve from the weak sidewall with dynamic collapse is an important part of the preoperative evaluation. Our workhorse for repair of static obstruction is the combination of spreader grafts and flaring sutures, which together create a significant increase in the intranasal valve area. Dynamic collapse of the sidewall is corrected with cartilaginous batten grafts designed to increase sidewall rigidity. Less common causes of valve obstruction, such as tip ptosis, facial paralysis, cicatricial stenosis, Mohs reconstruction, and paradoxical lateral crura, are repaired by more individualized techniques.