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The internal nasal valve: a validated grading system and operative guide.

B Patel1, J S Virk2, P S Randhawa2

  • 1Rhinology Department, Royal National, Throat, Nose and Ear Hospital, Gray's Inn Road, London, WC1X 8DA, UK. bhavesh.patel7@nhs.net.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|October 8, 2018
PubMed
Summary

A new grading system for the internal nasal valve (INV) effectively assesses nasal obstruction. This reliable method shows significant improvements in patient outcomes after surgery.

Keywords:
Nasal inspiratory peak flowNasal obstructionSeptoplastySeptorhinoplastyValve

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Area of Science:

  • Otolaryngology
  • Rhinology
  • Surgical Innovation

Background:

  • Nasal obstruction is a common, subjective symptom impacting quality of life.
  • The internal nasal valve (INV) is a critical determinant of nasal airflow resistance.
  • Objective assessment of the INV has been challenging.

Purpose of the Study:

  • To develop and validate a novel static grading system for the internal nasal valve (INV).
  • To assess the reliability and reproducibility of the INV grading system.
  • To correlate INV grading with objective and subjective measures of nasal obstruction.

Main Methods:

  • Prospective study of 28 patients undergoing primary external functional septorhinoplasty.
  • Blinded, independent assessment of INV scores by surgeons pre- and postoperatively.
  • Evaluation of inter-rater and test-retest reliability using Cronbach's alpha.

Main Results:

  • Excellent inter-rater (Cronbach's alpha=0.936) and test-retest (Cronbach's alpha=0.920) reliability for the INV grading system.
  • Statistically significant improvements in subjective and objective postoperative outcomes.
  • Demonstrated correlation between INV grade and nasal inspiratory peak flows.

Conclusions:

  • A novel, easy-to-interpret static INV grading system is reliable and reproducible.
  • This grading system offers clinical value in managing nasal obstruction.
  • The validated system aids in surgical planning and outcome assessment for septorhinoplasty.