Nasal Obstruction Surgery Helps Patients Breathe Easier

A minimally invasive surgical technique shows significant improvement in relieving nasal obstruction when compared to more traditional open rhinoplasty, according a new study.

Researchers at Rush University Medical Center (Chicago, IL, USA) conducted a retrospective chart review on 12 patients who underwent intranasal Z-plasty over a 24-month period; all patients had previously undergone some type of surgical procedure such as rhinoplasty, septoplasty, turbinoplasty, or endoscopic sinus surgery, but none of the procedures improved their complaints of nasal obstruction. The patients were asked pre- and post-operatively to assess their nasal obstruction on a scale of zero-to-ten, with ten being total nasal obstruction and zero being perfect nasal airflow. The mean preoperative score was 7.17. The results showed that following the procedure the mean postoperative score was 3.25. Eleven patients noted significant improvement in airflow on both sides with the remaining patient noting significant improvement on one side only. None of the patients complained of the postoperative appearance of their noses. The study was published in the May 21, 2008, issue of the Archives of Facial Plastic Surgery.

"With open rhinoplasty, patients have to endure extended healing times, extensive tissue dissection, grafting, and use of foreign bodies for valve suppression, all of which can lead to major complications and alter the physical appearance of the nose,” said lead author otolaryngologist Jay Dutton, M.D. "The Z-plasty is relatively quick, painless, less invasive, and appears to be efficacious for nasal valve obstruction.”

The nasal valve plays a crucial role in determining the airflow characteristics of the nasal airway. Internal nasal valve collapse is one of the most common causes of nasal obstruction and can result in significant and problematic changes in airflow. Z-plasty is a minimally invasive procedure performed entirely from inside the nose under local anesthesia with conscious intravenous (IV) sedation. The technique involves the creation and transposition of two triangular flaps, which widen the valve angle and create a subtle tip rotation in order to improve nasal airflow. Small, Z-like incisions are made in the cartilage located inside the nostril of the nose to allow a segment of the upper cartilage of the nose to be removed. The flaps are then sutured into position.

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