Nasal congestion is extremely common and is caused by many different conditions. Chronic obstruction can significantly impair quality of life, decrease productivity, and interfere with sleep. Narrowing of the nasal valve is one common cause of obstruction which can be fixed with rhinoplasty. The nasal valve is the area of the nose through which the majority of air flows. The internal and external portions of this valve can be corrected with surgery. An interesting recent article by Barham et al from Australia looked at two different ways to fix nasal obstruction at the external nasal valve.
The first technique they examined, called the cephalic crural turn-in, uses cartilage that is already present in the nose, folding an extra portion of it over to widen the nasal valve. The second technique uses patients’ own rib cartilage to add extra structure and support to this region.
In this study, both methods were shown to improve objective and subjective measures of nasal function as well as cosmetic outcome. Using a patient’s native cartilage when possible may confer a slight cosmetic advantage. In difficult or revision cases, though, the use of rib cartilage is an acceptable and effective alternative.
Often, the rhinoplasty technique chosen by the surgeon depends on an individual patient’s anatomy and whether this anatomy has been altered by prior surgery, trauma, or disease. As a surgeon it is important to learn multiple techniques and to study their effects on patients’ functional and cosmetic satisfaction over time.