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Background: The septal L-strut extension graft (SLEG) consists of anterior extended spreader graft and caudal septal extension graft. SLEG is used to increase the anterocaudal projection from a low-profile nose by creating the de-novo septum. This retrospective study verified the effectiveness of SLEG in improving the nasal function in East Asians., Materials: Medical records of patients who underwent septorhinoplasty with SLEG were retrospectively reviewed. The clinical features showed under-projected lower two-thirds of the nose with septal deviation, saddle nose, and short nose. We analyzed the post-operative changes in the NOSE score and variables of nasal geometry measured using acoustic rhinometry through long-term follow-up., Results: Patients were divided into two groups, those who underwent SLEG with turbinoplasty (Group A) and SLEG alone (group B). The NOSE scores decreased significantly in groups A and B, and the improvement was statistically more significant in Group A (p < 0.05). Acoustic rhinometry showed an increase in nasal cavity volume (VOL1) on the deviated side in Group A, and an increase in minimal cross-sectional area 1 (MCA1) on the deviated side in Group B (p < 0.05). The non-deviated side did not show significant reduction in MCA1 and VOL1 after SLEG with or without turbinoplasty. Thus, SLEG, by itself, improved airway function in East Asians., Conclusions: SLEG has proven to be valuable in improving nasal function., (Copyright © 2024 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Background: Nasal airway obstruction (NAO) is a highly prevalent disorder. Septal swell body (SSB) hypertrophy is an often overlooked contributor to NAO. SSB treatment may relieve symptoms of NAO. The objective of this study was to assess the clinical use of a temperature-controlled radiofrequency (TCRF) device to treat SSBs to improve symptoms in adults with NAO., Methods: In this prospective, multicenter, open-label, single arm study, patients with severe or extreme NAO related to SSB hypertrophy received bilateral TCRF treatment in the SSB area. The primary endpoint was improvement in Nasal Obstruction Symptom Evaluation (NOSE) Scale scores from baseline to 3 months postprocedure. A subset of study patients underwent computed tomography (CT) imaging to evaluate posttreatment changes in SSB size., Results: Mean NOSE Scale scores significantly improved from 73.5 (SD 14.2) at baseline to 27.9 (SD 17.2) at 3 months postprocedure, a reduction of -45.3 (SD 21.4, 95% confidence interval [CI]: -50.4 to -40.1; p < 0.0001); the responder rate was 95.7% (95% CI: 0.88 to 0.99; p < 0.0001). CT evaluation at 3 months showed statistically significant reductions in the SSB with the greatest reduction in the middle thickness (mean change -3.4 [SD 1.8] mL, 95% CI: -4.0 to -2.8; p < 0.0001). Minimal adverse events with any relationship to the device or procedure were reported; none were serious in nature and no septal perforations occurred., Conclusions: This study demonstrates that TCRF treatment of SSB hypertrophy is well tolerated and effective at reducing both SSB size and symptoms of NAO at 3 months posttreatment., (© 2023 ARS-AAOA, LLC.)

Objectives: The effects of different climatic conditions on the quality of life (QoL) of patients following septoplasty or septorhinoplasty were investigated., Methods: A total of 89 patients (47 males and 42 females) underwent either septoplasty or septorhinoplasty during the summer (summer group, n = 42) or winter (winter group, n = 47) season. To assess QoL, SinoNasal Outcome Test (SNOT)-22, Nasal Obstruction Symptom Evaluation (NOSE) scale, and Visual Analogue Scale were used. Postoperative (PO) pain, bleeding, and symptoms related to nasal packing (eating and sleep problems) were also evaluated., Results: PO pain scores were lower in the winter group than that in the summer group (p<0.05). After pack removal, there was a slight serohemorrhagic nasal discharge in 2.1% of the patients in the winter group, but no patient required intervention. Slight leakage was detected in 47.6% of the patients and 2.4% of the patients called for intervention (p<0.05) in the summer group. The SNOT-22 values did not differ between the groups (p>0.05). NOSE scores in the winter group were higher than that in the summer group (p<0.05). In each group, SNOT-22 (p adjusted <0.175) and NOSE scores (p<0.05) were lower at 1 month after surgery. The winter group patients rated headache, facial pain, and nasal crusting higher than those in the summer group did (p<0.05). However, nasal discharge and loss of smell were less troubling in the summer group than that in the winter group (p<0.05)., Conclusion: Regardless of climate or season, septoplasty or septorhinoplasty increases patients' QoL. However, problematic PO bleeding was detected at a higher frequency in patients who underwent surgery in summer. The advantage of surgery in winter is that it leads to less frequent problematic bleeding PO., Competing Interests: Declaration of Competing Interest None of the authors declare any conflicts of interest., (Copyright © 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Objective: To evaluate the psychometric properties of the nasal obstruction symptom scale within a sample of pediatric patients undergoing septoplasty or functional septorhinoplasty., Study Design: This was a prospective study with nasal obstruction symptom scale evaluations conducted pre- and postoperatively., Setting: A tertiary care pediatric hospital., Subjects and Methods: Pediatric patients underwent septoplasty or functional septorhinoplasty (FSR) from January 2013 to January 2017. Reliability of the scale was assessed through measures of internal consistency. In addition, item response models of each item were evaluated to assess how well each item captured individuals with varying levels of nasal obstruction. Study authors assessed face validity, and construct validity was assessed by correlation measures between items and exploratory factor analysis., Results: A total of 136 patients, ages 8 to 18 years with a mean age of 15.7 ± 2.1 years, completed pre- and postoperative evaluations. Internal consistency of the scale was high (Cronbach's α = 0.83). Predominantly a unidimensional scale resulted from exploratory factor analyses. Item response models indicate questions capture low to moderate levels of nasal obstruction within this population. Additional analyses show the scale functions similarly between septoplasty and FSR patients., Conclusion: The Nasal Obstruction Symptom Evaluation scale is a robust tool that may be incorporated as a subjective evaluation of severity of nasal obstruction among pediatric patients undergoing a septoplasty or functional septorhinoplasty.

Purpose: Functional and aesthetic results after septorhinoplasty (SRP) are often not clearly demonstrated. There is still an open topic in the literature about analysis of aesthetic, functional results and patients' satisfaction after SRP. The aim of our study is to determine patients' satisfaction after SRP and concomitant radiofrequency of the inferior turbinate (RF) regarding nose appearance and improvement of symptoms, using patient reported outcome measures (PROMs)., Methods: ROE questionnaire and the NOSE scale were used for a retrospective evaluation to assess patient's satisfaction in 369 patients undergoing SRP surgery from 2003 to 2016. Two additional questions were asked to confirm satisfaction following surgery., Results: 258 patients completed the questionnaires (71.7%). The global average ROE score was 18.14 (75.6%). The percentage of satisfaction of aesthetic result was 87.3%, in particular 10.5% were very happy, 57% very much satisfied and 19.8% moderately satisfied. The global post-operative average NOSE score was 13.1 with the resolution of nasal obstruction in 72.1% cases and a marked improvement in 9.3%. The results of the two additional questions showed that 81% of patients would undergo the procedure again if required and 72.1% of patients were globally satisfied., Conclusions: Our study demonstrates the utility of PROMs in evaluating aesthetic and functional results after SRP and simultaneous RF. In our series, the patients undergoing SRP and RF are generally satisfied by the functional and aesthetic results. This kind of assessments should be the most common post-operative evaluation methods in this surgery.

Objective: This study assessed disease-specific quality-of-life outcomes among pediatric patients undergoing septoplasty or functional septorhinoplasty. The Nasal Obstruction Symptom Evaluation (NOSE) score was obtained pre- and post-operatively. Additional analyses determined whether demographics, nasal trauma, prior nasal surgery, or allergic rhinitis history affected NOSE scores., Methods: Patients undergoing septoplasty or functional septorhinoplasty were evaluated prospectively at a tertiary children's hospital. NOSE scores were assessed pre- and post-operatively. Change in NOSE score was analyzed using the Wilcoxon Signed Rank test, while multiple regression analysis evaluated factors associated with NOSE score change., Results: 136 patients (mean age 15.7 ± 2.1 years) were evaluated; 52 (38.2%) underwent septoplasty while 84 (61.8%) underwent functional septorhinoplasty. Mean follow-up was 3.6 ± 5.1 months. There was a statistically significant decrease in NOSE score from pre-operative septoplasty and functional septorhinoplasty: median = 75 to post-operative septoplasty: median = 20 (z = -5.9, p < 0.001) and functional septorhinoplasty: median = 15 (z = -7.9, p < 0.001). Gender, age, nasal trauma, prior nasal surgery, and allergic rhinitis did not have a significant effect on NOSE score change for either group. Additional surgery at the time of procedure was not a confounding variable in the relationship between surgery type and NOSE score. A NOSE Scale reliability analysis demonstrated high internal consistency with Cronbach's α of 0.83 across septoplasty and functional septorhinoplasty patients., Conclusion: There was significant improvement in disease-specific quality-of-life in pediatric patients undergoing septoplasty or functional septorhinoplasty. Gender, nasal trauma, prior nasal surgery, and allergic rhinitis did not significantly affect NOSE scores in either group., (Copyright © 2018 Elsevier B.V. All rights reserved.)

The literature still lacks a review regarding PROs applied for rhinoplasty. Thus, we performed a systematic review of the literature to identify PROMs that assess patient satisfaction and quality of life after rhinoplasty. The aim of our study was to identify existing questionnaires and to summarize their development, psychometric properties, and content. A multi-step search of the web-based PubMed database from the National Library of Medicine was performed to identify PROMs that are designed to evaluate satisfaction and quality of life following rhinoplasty. Each potential PROM was examined by three independent reviewers for adherence to inclusion/exclusion criteria. Questionnaires included in the analysis were appraised for their adherence to international guidelines for the development and validation of health outcome questionnaires, as outlined by the Scientific Advisory Committee of the Medical Outcome Trust and the U.S. Food and Drug Administration. Our search generated a total of 457 articles, 351 that were retrieved in the primary search, and 106 that were found in the references of the first set of articles. The process of development and validation of each of the included PROMs was examined. Only ten of these were identified as surgery-specific questionnaires about rhinoplasty. These were divided into three categories: (1) functional self-assessment (Nasal Surgical Questionnaire, Nasal Obstruction Symptoms Evaluation Scale, and Nasal Obstruction Septoplasty Effectiveness); (2) aesthetic self-assessment (Utrecht Questionnaire, FACE-Q rhinoplasty module, Glasgow Benefit Inventory); and (3) aesthetic and functional self-assessment (Rhinoplasty Outcomes Evaluation), Functional Rhinoplasty Outcome Inventory 17, RHINO Scale, and Evaluation of Aesthetic Rhinoplasty Scale).

Objective: The Nasal Obstruction Symptom Evaluation (NOSE) scale has been used to demonstrate that surgery improves nasal obstruction, but no study has directly compared surgical techniques. We performed a retrospective study comparing NOSE scores to quantify the effects of spreader grafting on postoperative nasal patency., Methods: We compared NOSE scores of patients who underwent septoturbinoplasty to open septorhinoplasty with spreader graft placement. We used a paired samples t test to evaluate the difference between pre- and postoperative NOSE scores and the improvement in NOSE score between patients who underwent septoturbinoplasty and those who underwent open septorhinoplasty with spreader graft placement., Results: Surgery reduced NOSE scores by an average of 46 points ( P < .001). The mean differences in NOSE score across all time points after septoturbinoplasty and septorhinoplasty with spreader graft placement was 40 and 49, respectively. The mean improvement in NOSE score at the second follow-up appointment was 27 for patients who had undergone septoturbinoplasty and 51 for patients who had undergone septorhinoplasty with spreader graft placement ( P = .04)., Conclusion: This is the largest study quantifying the effect of spreader grafting. Greater improvement was observed from septorhinoplasty with spreader graft placement than septoturbinoplasty, and this improvement persisted over time.

Background: There is a lack of medical literature demonstrating a positive correlation between subjective and objective results in functional nasal surgery., Objective: The author presents his experience measuring nasal function subjectively and objectively before and after functional nasal surgery., Methods: Between March 2011 and June 2012, a total of 119 consecutive patients with nasal obstruction underwent rhinoplasty with a variety of septorhinoplasty techniques. Results were evaluated with a scientifically validated patient questionnaire as well as pre- and postoperative rhinomanometry measurement comparisons. Preoperative and postoperative rhinomanometry measurements were standard protocol, and the rhinomanometry measurements were designed as a prospective study., Results: Ninety of the 119 patients had postoperative rhinomanometry measurements that could be compared with preoperative values, and these patients were included in the study. Statistically significant subjective and objective functional improvements were reported in 98.9% and 95.6% of patients, respectively, while 94.4% of patients had both subjective and objective statistically significant functional improvement. A statistically significant correlation between the subjective and objective improvements was noted., Conclusions: The findings provide statistically significant evidence to support surgical treatment of nasal obstruction., Level of Evidence: 3.

Key Points Nasal valve treatment with TCRF results in NAO symptom improvement in the presence of septal deviation. Severe septal deviation does not impact the beneficial effect of TCRF nasal valve treatment. Symptoms improve with TCRF nasal valve treatment even if septal deviations involve the nasal valve. [ABSTRACT FROM AUTHOR]

Objective(s): It was the first study to apply and compare two CT methods to assess the validity and clinical significance of structural alterations of the nasal valve in patients with cleft lip nose for assessing nasal ventilation disturbance. Methods: The study collected data from the NOSE score, as well as internal nasal valve area, internal nasal valve angle, external nasal valve area, and septal deviation angle, to evaluate the differences and correlations between those factors in patients with cleft lip and nose. Results: There were significant differences among INV transverse and coronal area and INV angle on different axial standardized planes between clefted side and non-clefted side. There were statistically significant negative correlations between NOSE scores and those indicators of standard plane and acoustic-axis standardized coronal plane. NOSE score and NSD angle were the indicators of significant differences in the measured data of different complications groups (p = 0.002, p = 0.017). The correlation comparison showed that two standardized CT imaging transverse planes have similar correlations in NOSE score, NSD angle, and complications. Conclusion: The results of the two CT evaluation methods showed that there was a significant difference in nasal valve area on the cleft and non-cleft sides, which was significantly associated with nasal ventilation disturbance. The CT evaluation method based on standard axial 3D reconstruction is more convenient to use in the clinic, can be used for pre-surgical evaluation of nasal repair in patients with secondary nasal deformities of unilateral cleft lip, and is valuable for treatment. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Abstract Background The objective of this study was to evaluate long‐term symptom improvements in patients with nasal airway obstruction (NAO) secondary to nasal valve collapse (NVC) following minimally invasive temperature‐controlled radiofrequency (TCRF) treatment. Methods A prospective, single‐arm, multicenter study in patients >18 years with NAO due to NVC. Inclusion criteria were response to nasal valve dilation (e.g., modified Cottle maneuver) and baseline Nasal Obstruction Symptom Evaluation (NOSE) Scale score ≥60. Patients were treated in the nasal valve region with a TCRF device and followed through 2 years. A responder was ≥20% reduction NOSE Scale score or ≥1 reduction in severity class. Results A total of 122 patients were treated and 91 reached 2 years. The mean baseline NOSE Scale score was 80.3 (95% CI, 78.1–82.6). The adjusted mean change in score at 2 years was −45.8 (95% CI, −53.5 to −38.1), p

Our study aims to investigate the seasonal effects on the breath and quality of life (QoL) of patients who underwent septorhinoplasty (SRP). A total of 52 patients who underwent SRP between 2018-2023 were included in the study. Two groups those who operated in the winter (winter group, n=26) and those who performed in the summer (summer group, n=26) were evaluated with the NOSE (Nasal Obstruction Symptom Evaluation) scale to reveal the QoL after surgery. Compared with the summer group, NOSE scores in the winter group showed a statistically significant difference (p [Med-Science 2023; 12(4.000): 1210-2]

Background/Aim: The Nasal Obstruction Symptom Evaluation (NOSE) scale is a validated, reliable, and feasible instrument used to evaluate nasal obstruction severity. We aimed to assess patient satisfaction using the NOSE score after revision rhinoplasty with free diced cartilage (fDC) grafts. Methods: In this cross-sectional study, 36 patients who underwent a revision rhinoplasty procedure completed the Turkish version of the NOSE questionnaire before and six months after rhinoplasty. Pre and postoperative NOSE scores were compared using the Mann Whitney U test. Results: The pre and postoperative total mean NOSE scores were 68.06 and 8.47, respectively. The NOSE score significantly decreased six months after rhinoplasty surgery (P<0.001). Adapting to exercise was the parameter with the highest improvement rate. Conclusion: The outcome of the NOSE questionnaires in patients with nasal deformities shows that a revision rhinoplasty surgery with the placement of fDC grafts contributes to the improvement of nasal functions. The Turkish version of the NOSE scale is a useful tool to assess patient satisfaction among the Turkish population. [ABSTRACT FROM AUTHOR]

Background: The objective of this study was to evaluate long‐term symptom improvements in patients with nasal airway obstruction (NAO) secondary to nasal valve collapse (NVC) following minimally invasive temperature‐controlled radiofrequency (TCRF) treatment. Methods: A prospective, single‐arm, multicenter study in patients >18 years with NAO due to NVC. Inclusion criteria were response to nasal valve dilation (e.g., modified Cottle maneuver) and baseline Nasal Obstruction Symptom Evaluation (NOSE) Scale score ≥60. Patients were treated in the nasal valve region with a TCRF device and followed through 2 years. A responder was ≥20% reduction NOSE Scale score or ≥1 reduction in severity class. Results: A total of 122 patients were treated and 91 reached 2 years. The mean baseline NOSE Scale score was 80.3 (95% CI, 78.1–82.6). The adjusted mean change in score at 2 years was −45.8 (95% CI, −53.5 to −38.1), p < 0.001; a 57.0% improvement. The 2‐year responder rate was 90.1% (95% CI, 82.3%–94.7%). Significant and sustained symptom improvement was achieved in subpopulations based on sex, age, body mass index, baseline NAO severity, nasal surgery history, NVC mechanism, septal deviation, and other anatomic contributors of NAO. No serious adverse events with a relationship to the study device and/or procedure were reported. Conclusions: Minimally invasive TCRF device treatment of the internal nasal valve for NAO is well tolerated and leads to significant and sustained improvement in NAO symptom severity through 2 years, including in patients with both static and dynamic NVC, septal deviation, turbinate enlargement, or prior nasal surgery. Level of Evidence: 2b. [ABSTRACT FROM AUTHOR]

Our study aims to investigate the seasonal effects on the breath and quality of life (QoL) of patients who underwent septorhinoplasty (SRP). A total of 52 patients who underwent SRP between 2018-2023 were included in the study. Two groups those who operated in the winter (winter group, n=26) and those who performed in the summer (summer group, n=26) were evaluated with the NOSE (Nasal Obstruction Symptom Evaluation) scale to reveal the QoL after surgery. Compared with the summer group, NOSE scores in the winter group showed a statistically significant difference (p<0.05). Septorhinoplasty is a surgical procedure expected to increase the QoL of patients regardless of the season and climate. The low mean NOSE score observed in the winter showed that the postoperative patient comfort was significantly higher compared who underwent surgery in the summer. Therefore, encouraging patients to undergo surgery intensively during the winter months in SRP will be positive for postoperative QoL. Future studies may reveal more illuminating results for increasing patient comfort by considering different surgical techniques, climates, and months. [ABSTRACT FROM AUTHOR]

Abstract Background Rhinoplasty is considered one of the most challenging operations in the plastic surgery. Esthetic or functional reshaping purposes of the nose can be stressing for both surgeon and patient. Different types of graft materials have been used to perform augmentation rhinoplasty. Free diced cartilage (FDC) was recently established in dorsal nasal rhinoplasty for better handling of irregularities as well as contour deficits of dorsal nasal outcomes. The main purpose of the present study is to assess the effectiveness of the use of FDC in dorsal nasal and nasal tip rhinoplasty and evaluation of its advantages and disadvantages using the validated Nasal Obstruction Symptom Evaluation (NOSE) scale and the Rhinoplasty Outcome Evaluation (ROE) questionnaire to assess nasal obstruction and patient satisfaction. Results This prospective study was conducted between March 2018 and December 2019, 20 patients were included and planned for rhinoplasty using FDC to camouflage dorsal and nasal tip deformities. All patients (11males and 9 females) underwent open rhinoplasty through inverted v columellar incision, taken FDC from nasal septum. A statistical significant difference between pre- and post-operative NOSE scores was found (P

Background: Nasal valve collapse is one of several causes of nasal obstruction. The safety and efficacy of a temperature‐controlled radiofrequency (RF) device for the treatment of the nasal valve for nasal airway obstruction (NAO) has been established in single‐arm studies. The objective of this trial was to compare active device treatment against a sham procedure (control). Methods: In a prospective, multicenter, single‐blinded, randomized controlled trial (RCT), patients were assigned to bilateral temperature‐controlled RF treatment of the nasal valve (n = 77) or a sham procedure (n = 41), in which no RF energy was transferred to the device/treatment area. The device was applied to the mucosa over the lower lateral cartilage on the lateral nasal wall. The primary endpoint was responder rate at 3 months, defined as a ≥20% reduction in Nasal Obstruction Symptom Evaluation (NOSE)‐scale score or ≥1 reduction in clinical severity category. Results: At baseline, patients had a mean NOSE‐scale score of 76.7 (95% confidence interval [CI], 73.8 to 79.5) and 78.8 (95% CI, 74.2 to 83.3) (p = 0.424) in the active treatment and sham‐control arms, respectively. At 3 months, the responder rate was significantly higher in the active treatment arm (88.3% [95% CI, 79.2%‐93.7%] vs 42.5% [95% CI, 28.5%‐57.8%]; p < 0.001). The active treatment arm had a significantly greater decrease in NOSE‐scale score (mean, −42.3 [95% CI, −47.6 to −37.1] vs −16.8 [95% CI, −26.3 to −7.2]; p < 0.001). Three adverse events at least possibly related to the device and/or procedure were reported, and all resolved. Conclusion: This RCT shows temperature‐controlled RF treatment of the nasal valve is safe and effective in reducing symptoms of NAO in short‐term follow‐up. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate psychosocial distress and improvement in quality of life (QoL) of patients undergoing rhinoplasty and compare the level of distress associated with the types of rhinoplasty. A total of 79 patients who underwent external rhinoplasty were enrolled in the study. The patients were grouped due to primary, secondary, functional and cosmetic rhinoplasty. The patients were evaluated four times: preoperative evaluation, 4th, 12th, and 24th weeks postoperatively and completed questionnaires including the rhinoplasty outcome evaluation (ROE) scale, nasal obstruction symptom evaluation (NOSE) scale, and Derriford Appearance Scale 24 every four visit. The revision cases and patients with cosmetic indication have more emotional distress than others at the preoperative and early postoperative period ( p < 0.005). However, the distress level equalize and return baseline values beyond 12 weeks. The ROE and NOSE scores of all patients were very significantly improved by the rhinoplasty ( p < 0.001). To our knowledge, this is the first study to evaluate changes in distress of patients undergoing rhinoplasty using DAS-24 scale. The psychosocial distress has a significant impact on quality of life and, therefore, it is an important factor to assess the success of surgery. In addition, regardless of initial demand and type of surgery, rhinoplasty provides improvement in nasal obstruction, and a positive impact on QoL in most of the patients undergoing rhinoplasty. [ABSTRACT FROM AUTHOR]