[Surgery of the narrow liminal valve extranasal let out: technic and biomechanical explanation]

Using cadaver material and drawings, the surgical procedure called "let out" of the nasal pyramid was described. It utilizes the principles of conservation of the skeletal integrity of the nasal dorsum of the "push down". This procedure is indicated in patients with a narrow valve and high thin nose, without vasomotor rhinopathy or allergy. A patient illustrates the good functional results of the surgery as shown by the base view and the secondary benefits from an appearance standpoint as shown by the profile view. We thought that we could explain the improved nasal ventilation by an augmentation of the cross section area of the nose at the valve. Measurements on the cadaver showed that the area was smaller after surgery. We hypothesized finally that the improved rigidity of the valve secondary to its shortening and the augmentation of the angle of the liminal valve created a conduit that allowed normal inspiratory flow through the nose.