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Lateral Support Maneuver: Validation of a Diagnostic Tool Specific to Dynamic Nasal Valve Collapse
Kaitlynne Y Pak1, Alberto Nunez, Matthew K Lee
1Division of Otolaryngology, Head and Neck Surgery, Cedars Sinai Medical Center, Los Angeles, CA.
Background:
The modified Cottle (MC) maneuver has limited clinical value due to a lack of specificity. The authors propose a variation utilizing only passive support of the lateral wall in dynamic lateral wall insufficiency (LWI), termed the "lateral support (LS) maneuver".
Objective:
Evaluate whether the LS maneuver reduces false positives in LWI diagnosis.
Methods:
This cross-sectional study involved 106 volunteers who were evaluated using the NOSE scale, Likert scale, and LWI grade to compare nasal breathing with no intervention (N) versus the MC and LS maneuvers.
Results:
In LWI grade 0, the LS showed no significant improvement compared with N. In LWI grade 1 to 3, the LS showed significant improvement in nasal breathing compared with N (paired t test, P <0.05), demonstrating specificity to the presence of LWI. MC had significant improvement in all LWI grades, including grade 0 (false positive). Both maneuvers demonstrated significant improvement across the NOSE severity categories.
Conclusions:
Our study demonstrates both the MC and LS maneuvers have high positivity rates across the NOSE severity categories. However, a positive response to the LS maneuver was seen only in those with true, objective LWI (grades 1-3), demonstrating greater specificity than the MC maneuver in assessing dynamic nasal valve collapse.
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