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In cases of narrowing of the internal nasal valve angle, we address all structures that commonly contribute to the internal valve area obstruction. We term this the 'triple-procedure technique'. The aim of this study was to assess the efficacy of this technique in improving patients' subjective nasal patency. A prospective longitudinal case study was conducted in a tertiary hospital in northeast of England. All consecutive patients who complained of nasal obstruction and were diagnosed with the internal nasal valve angle narrowing due to septal deviation were offered to have a triple-procedure operation (septoplasty, turbinate surgery and internal nasal valve surgery). Patients completed a validated nose-related questionnaire (Nasal Obstruction Symptom Evaluation (NOSE)) preoperatively, which was repeated 3 months after the operation. The change in NOSE score was the outcome measure. Eight of the nine patients recruited to the study completed the questionnaires (88% response rate). The total and the domain scores improved after the operation, which were clinically and statistically significant. The effect size proved to be very large (total NOSE score effect size, 4.0). Our study shows that addressing all three structures commonly affecting the internal valve area is an effective technique in improving the obstruction caused by the narrow internal nasal valve angle. [ABSTRACT FROM AUTHOR]

Purpose: It is unclear if septal deviation at the insertion points to the nasal cavity is associated with the overall septal deviation. This study aimed to assess septal deviation at the cribriform plate (CP) and maxillary crest (MC) using CT scans and to see if there was any correlation with overall septal deviation. Methods: All consecutive CT sinus scans between January 2020 and December 2021 were retrospectively reviewed. Patients were excluded if they had a history of head, nasal or facial trauma, or any previous nasal surgical procedure. Angles between the septum and MC and the septum and CP as well as maximal angle of septal deviation (MSD) were measured. Results: A total of 70 scans were included in the final analysis. The mean MSD was 8.14°. The mean septal deviation was 0.89° at the CP and 2.02° at the MC. The correlation coefficient between the deviation at the CP and MSD was 0.025 and between the deviation at the MC and MSD was 0.321. Conclusion: Our data reveal a positive correlation between septal deviation at the floor of the nose and overall septal deviation; this was not observed at the septal deviation at the roof. This could be explained due to the inherent tilt in the cribriform plate or by earlier ossification and fixation of the septum during its development at its insertion to the roof, thereby allowing further growth and potential for deviation of the lower part of the septum and its insertion to the floor. [ABSTRACT FROM AUTHOR]