Clinical and functional analysis of the results of stabilization of lateral structures of the nose in primary rhinoseptoplasty

Objective. To evaluate the clinical and functional effectiveness of lateral nasal wall stabilization during primary rhinoseptoplasty in patients with functional insufficiency of the internal nasal valve using a combination of objective and subjective assessment methods.
Material and methods. In this prospective single-center study, 30 patients (7 men and 23 women) aged 18–40 years with complaints of impaired nasal breathing associated with functional insufficiency of the internal nasal valve were evaluated. All patients underwent function-oriented rhinoplasty, including septal correction and reconstruction of the nasal valve area using various lateral wall stabilization techniques (spreader grafts, autospreader flaps, lateralizing sutures, and lateral crural strut grafts). Treatment outcomes were assessed preoperatively and at 6 months postoperatively. Objective evaluation included acoustic rhinometry, active anterior rhinomanometry, endoscopic assessment of the nasal valve region, and computed tomography with morphometric analysis. Subjective nasal breathing and patient satisfaction were assessed using the validated NOSE and SCHNOS questionnaires.
Results. At 6 months postoperatively, a statistically significant improvement in both objective and subjective indicators of nasal airflow was observed. Acoustic rhinometry demonstrated a significant increase in the minimal cross-sectional area and nasal cavity volume (p<0,05), indicating anatomical widening of the internal nasal valve region. Active anterior rhinomanometry revealed a marked reduction in both inspiratory and expiratory airflow resistance (p <0,001). Endoscopic examination and computed tomography confirmed an increase in the internal nasal valve angle, a reduction in the severity of dynamic lateral wall collapse, and an enlargement of the nasal airway cross-sectional area (p<0,05). Subjective assessment showed a significant decrease in NOSE scores and in the functional component of the SCHNOS questionnaire (SCHNOS-O) (p 0,05).
Conclusion. The obtained results indicate that stabilization of the lateral nasal structures during rhinoseptoplasty is an effective approach for restoring physiological nasal aerodynamics and preventing postoperative nasal obstruction, providing a sustained functional benefit without adversely affecting patients’ subjective assessment of aesthetic outcomes.
Keywords: rhinoplasty, nasal obstruction, acoustic rhinometry, functional surgical procedures, dynamic nasal valve collapse, internal nasal valve
Conflict of interest. The authors declare no conflict of interest.
Funding. The study was performed without external funding.