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Functional effects of alar cartilage malposition

M B Constantian1

  • 1Department of Surgery (Plastic Surgery), Nashua Memorial Hospital, NH 03060.

Annals of Plastic Surgery
|June 1, 1993
PubMed
Summary

Alar cartilage malposition causes external nasal valve incompetence and airway obstruction. Surgical correction significantly improves nasal airflow, even without addressing septal issues.

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Area of Science:

  • Otolaryngology
  • Plastic Surgery
  • Rhinology

Background:

  • Nasal airway obstruction is commonly linked to septal deviation or inferior turbinate hypertrophy.
  • External nasal valve incompetence, often due to alar cartilage malposition, is a less recognized cause of obstruction.
  • This condition can stem from postsurgical or congenital factors.

Purpose of the Study:

  • To evaluate the efficacy of surgical correction for external nasal valve incompetence caused by alar cartilage malposition.
  • To analyze the impact of alar cartilage relocation on nasal airflow and alar base width.

Main Methods:

  • Retrospective analysis of 27 patients with alar cartilage malposition treated for external nasal valvular incompetence.
  • Rhinomanometry was used to measure total nasal airflow before and after surgical correction.
  • Surgical techniques included composite conchal cartilage/skin grafts and alar cartilage relocation.

Main Results:

  • Surgical correction of alar cartilage malposition increased total nasal airflow from 99 +/- 17 ml to 190 +/- 37 ml per 14 seconds.
  • Patients undergoing only external valvular reconstruction showed similar airflow improvements compared to those with additional septal pathology correction.
  • Alar cartilage relocation effectively narrowed the alar base without requiring alar wedge resection.

Conclusions:

  • Alar cartilage malposition is a significant contributor to external nasal valve incompetence and nasal airway obstruction.
  • Surgical correction of alar cartilage malposition provides substantial improvement in nasal airflow.
  • The described surgical principles are effective for both primary and secondary rhinoplasty patients experiencing valvular incompetence.

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