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Combining Spreader Grafts with Suture Suspension for Management of Narrow Internal Nasal Valve Angles.

Objective
The present study aimed to evaluate the long-term results of combining spreader grafts with lateral suspension techniques for management of narrow internal nasal valves.


Methods
This prospective study included 79 patients who underwent surgical interference for dysfunctional nasal valve. The surgical intervention was a combination of two commonly used techniques for management of internal nasal valve dysfunction: spreader graft insertion and lateral suspension of the upper lateral cartilages. The patients were assessed using the nasal obstruction symptom evaluation (NOSE) tool, computed tomography (CT) scans, and endoscopic examinations.


Results
All patients reported initial improvement and satisfaction in nasal breathing. Seventy-two patients (91%) reported sustained relief of nasal breathing for at least 3 years postoperatively. The mean NOSE scores decreased from 69.8 to 20.65 postoperatively. The internal nasal valve angle, as measured endoscopically, increased from 7.23° to 13.05° on the right side and from 6.75° to 11.98° on the left side; the increase was statistically significant. The angle, as measured on axial CT scans, increased from 8.11° to 14.15° on the right side and from 6.98° to 12.13° on the left side' this increase, too, was statistically significant.


Conclusion
Combining spreader grafts with lateral suspension sutures provide good, stable, and sustained repair of dysfunctional narrowed internal nasal valves.