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Related Experiment Video

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Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation

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Nasal strips for evaluating and classifying valvular nasal obstruction.

Ronald P Gruber¹, Alexander Y Lin, Todd Richards

¹Division of Plastic and Reconstructive Surgery, Stanford University, CA, USA. rgrubermd@hotmail.com

Aesthetic Plastic Surgery

|November 18, 2010

Summary

A new nasal strip test effectively classifies inspiratory nasal function related to upper and lower lateral cartilage (ULC/LLC) dysfunction. This BR test is more specific and powerful than the Cottle sign for evaluating nasal airway obstruction.

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Area of Science:

Otolaryngology
Rhinology
Nasal Airway Surgery

Background:

Upper lateral cartilage (ULC) and lower lateral cartilage (LLC) can be functionally abnormal despite a normal appearance.
The Cottle sign offers a subjective estimation of nasal obstruction but lacks precision in locating the issue.
A specific diagnostic tool is needed to differentiate ULC and LLC contributions to nasal airway obstruction.

Purpose of the Study:

To evaluate the efficacy of a novel nasal strip test in distinguishing functional abnormalities of the ULC and LLC.
To compare the diagnostic accuracy of the new test with the traditional Cottle sign.
To correlate test results with surgical outcomes in patients with nasal valve dysfunction.

Main Methods:

Thirty patients with symptoms of nasal valve obstruction underwent the Cottle test and a Breathe-Rite nasal strip test.
The nasal strip was applied to both the middle and lower thirds of the nose (rims).
Patients classified their inspiratory improvement using a BR scale (BR 0-III), correlating with ULC/LLC involvement.

Main Results:

The Cottle test demonstrated low specificity, with most patients showing a positive result.
The BR classification proved specific, correlating with functional outcomes in 27 out of 30 patients.
A significant correlation (P = 0.00257) was found between physical findings and the BR score.

Conclusions:

Nasal strips provide an easy and effective method for classifying inspiratory nasal function related to ULC/LLC cartilages.
The BR test offers superior specificity and diagnostic power compared to the Cottle sign for nasal airway obstruction.
This classification aids in guiding surgical interventions for internal and external nasal valve correction.