Functional rhinoplasty with batten and spreader grafts for correction of internal nasal valve incompetence

OBJECTIVE: We a describe technique for correction of internal nasal valve incompetence (INVI) using functional rhinoplasty (FRP) with combined cartilaginous batten and spreader grafts and report the functional and cosmetic outcomes.

DESIGN: Prospective series using subjective improvement in nasal airway and quality of life.

SETTING: Subregional ENT centre, one operating rhinologist.

PARTICIPANTS: Twenty-three consecutive adults presenting to ENT department at North Hertfordshire NHS Trust with symptomatic INVI.

MAIN OUTCOMES MEASURES: Pre and post-operative symptom scores for nasal obstruction and its impact on overall quality of life using visual analogue scales (1-100mm). Cosmetic outcome graded using subjective scores. Statistical analysis performed using the Wilcoxon signed rank test.

RESULTS: We found a median subjective improvement on the visual analogue scale of 55 mm for nasal patency (p<0.001) and of 49 mm for quality of life (p<0.001). Twenty-two patients felt that the appearance of their nose had not changed or had significantly improved post operatively.

CONCLUSION: Combined use of batten and spreader grafts for the correction of INVI in normal or narrow nasal vaults is effective without compromising cosmesis.