Evaluation of the Internal Nasal Valve using Computed Tomography Pre and Post Rhinoplasty and Its Correlation to Symptomatic Improvement

Abstract

Background: The INV area is the narrowest area of a nasal cavity, which is formed by the nasal septum, the caudal border of the upper lateral cartilage ULC, the head of the inferior turbinate, and the pyriform aperture and the tissues that surround it. Accurate evaluation of the INV is important to the workup for repair of problems that involve this area. The initial evaluation of the nasal valve occurs with the clinical examination, anterior rhinoscopy, the Cottle maneuver, and endoscopy, which all are used clinically to assess nasal airflow. Objective: This study aims to evaluate the internal nasal valve by using reformatted (CT) scans of the nasal airway pre and post rhinoplasty and its correlation to symptomatic improvement according to (NOSE) scale. Patients and Methods: This prospective study of twenty patients who were subjected to rhinoplasty at ENT departments of Ain-shams university hospitals. Results: This study included 20 cases of age's ranges from 20 to 30 years. The mean age among study cases was 23.8 ±3.22. There were 14 males and 6 females. So, the majority of cases (70%) were males. In our study, we detected that there is no significant correlation between CT scans analysis of the INV pre and post-rhinoplasty and there is no significant correlation between CT scans analysis of the INV and the NOSE score pre and post-rhinoplasty. On the other hand, there is high significant correlation between NOSE score pre and post-rhinoplasty. Conclusion: In our study, we detected that there is no significant correlation between CT scans analysis of the INV pre and post-rhinoplasty and there is no significant correlation between CT scans analysis of the INV and the NOSE score pre and post-rhinoplasty. Keywords: External nasal valve-internal nasal valve-nose obstruction symptomatic evaluation INTRODUCTION The airflow resistance provided by the airways during breathing is essential for good pulmonary function. Nasal airway resistance accounts for more than 50% of total airway resistance, most of this resistance occurs in the anterior part of the nose which called the nasal valve (1) .