Objective. To assess the outcomes of functional rhinoplasty for nasal valve incompetence and to evaluate an in-office test used to\nselect appropriate surgical techniques. Methods. Patients with nasal obstruction due to nasal valve incompetence were enrolled.The\nmodified Cottle maneuver was used to assess the internal and external nasal valves to help select the appropriate surgical method.\nThe rhinoplasty outcomes evaluation (ROE) formand a 10-point visual analog scale (VAS) of nasal breathing were used to compare\npreoperative and postoperative symptoms. Results. Forty-nine patients underwent functional rhinoplasty evaluation. Of those, 35\nisolated batten or spreader grafts were inserted without additional procedures. Overall mean ROE score increased significantly\n(P < 0.0001) from 41.9 Ã?± 2.4 to 81.7 Ã?± 2.5 after surgery. Subjective improvement in nasal breathing was also observed with the VAS\n(mean improvement of 4.5 (95% CI 3.8ââ?¬â??5.2) from baseline (P = 0.000)). Spearman rank correlation between predicted outcomes\nusing the modified Cottle maneuver and postoperative outcomes was strong for the internal nasal valve (Rho = 0.80; P = 0.0029)\nand moderate for the external nasal valve (Rho = 0.50; P = 0.013). Conclusion. Functional rhinoplasty improved subjective nasal\nairflow in our population. The modified Cottle maneuver was effective in predicting positive surgical outcomes.
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