Nasal Plastic Surgery Improves Airway Function

Nasal plastic surgery appears to improve nasal airway function in patients with severe nasal obstructions, according to a report in the September/October issue of Archives of Facial Plastic Surgery, one of the JAMA/Archives journals.

Obstruction of the nasal passages is one of the most common conditions treated by otolaryngologists and facial plastic surgeons, according to background information in the article. Common causes include septal deviation, which occurs when the wall separating the two nasal passages is crooked or off-center; valve insufficiency, caused by improper positioning or collapse of cartilage inside the nasal passages; and turbinate hypertrophy, when air flow is blocked by large or swollen turbinates, areas inside the nose covered by mucous membranes that help warm and filter incoming air. Surgical procedures to treat these types of conditions are collectively known as functional rhinoplasty.

Sam P. Most, M.D., formerly of the University of Washington School of Medicine, Cosmetic Surgery Center, Seattle, and now at Stanford University, Calif., evaluated 41 patients (27 men, 14 women, average age 41.5) with severe nasal obstruction for at least one year who subsequently underwent functional rhinoplasty at the center. Patients completed preoperative and postoperative evaluations, including questionnaires designed to assess the severity of their nasal obstruction and their quality of life. Patients were each given a score from zero to 100, with higher scores indicating more severe nasal obstructions.

The average score decreased significantly after surgery, from 58.4 to 15.7 after an average of 227 days. The researcher also examined groups of patients according to the specific procedure performed - including spreader grafting, septoplasty and turbinectomy - and found similar rates of improvement.

"Functional rhinoplasty techniques are effective in improving nasal airway function as measured by a patient-based, disease-specific, quality-of-life instrument," Dr. Most concludes. "The specific techniques considered to treat nasal obstruction can be tailored to address the areas of concern, including septal deviation, internal or external valve collapse and turbinate hypertrophy." (Arch Facial Plast Surg. 2006;8:306-309)