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Nasal Valve Malfunction Resulting From Resection of Cancer

Nasal Valve Malfunction Resulting From Resection of Cancer Abstract • Following cancer resection of the nasal unit, nasal valve malfunction is manifested by the symptoms of nasal stuffiness or difficulty getting air into the nostril. These symptoms occur in cases in which the resection is in the alar crease at the junction with the lateral sidewall of the nose. Wound scar contracture elevates the alar margin and causes the alar and lateral cartilages to move inward forming a visible and palpable shelf on the lateral wall of the nasal vestibule. This displacement of the alar and lateral cartilages and the rigid scar formed between these cartilages render the nasal valve immobile. Since it is easier to prevent nasal valve malfunction than to repair it later, wounds that bridge the alar crease or are located in either the alae or lateral sidewall and come within 1 mm of the alar crease with a total diameter of 1.0 cm should be repaired to prevent nasal valve malfunction. In the process of repairing deep defects, the overlapping region of the lateral crus of the alar cartilage and the lateral cartilage may be stabilized by a conchal cartilage graft. This cartilage graft may be used in combination with reconstruction of the nasal skin with a forehead flap and repair of the nasal lining. In the event that the nasal lining is intact, the cartilage graft may be used with a full-thickness skin graft. (Arch Otolaryngol Head Neck Surg. 1990;116:1419-1424) References 1. DeLara Galindo S, Cuspinera E, Ramirez LC. Anatomical and functional account on the lateral nasal cartilages . Acta Anat. 1977;97:393-399.Crossref 2. Zide BM. Nasal anatomy: the muscles and tip sensation . Aesth Plast Surg. 1985;9:193-196.Crossref 3. Stucker FJ, Smith TE. The nasal bony dorsum and cartilaginous vault . Arch Otolaryngol. 1976;102:695-698.Crossref 4. Converse JM. The cartilaginous structure of the nose . Ann Otolaryngol. 1955;64:220-229. 5. Zelnik J, Gingrass RP. Anatomy of the alar cartilage . Plast Reconstr Surg. 1979;64:650.Crossref 6. Sheen J. Aesthetic Rhinoplasty . St Louis, Mo: CV Mosby Co; 1978. 7. Burget GC, Menick FJ. The subunit principle in nasal reconstruction . Plast Reconstr Surg. 1985;76:239.Crossref 8. Burget GC. Aesthetic restoration of the nose . Clin Plast Surg. 1985;12:463-480. 9. Burget GC, Menick FJ. Nasal reconstruction: seeking a fourth dimension . Plast Reconstr Surg. 1986;78:145.Crossref 10. Burget GC, Menick FJ. Nasal support and lining: the marriage of beauty and blood supply . Plast Reconstr Surg. 1989;84:189-203.Crossref 11. Fleiss JL. Statistical Methods for Rates and Proportions . 2nd ed. New York, NY: John Wiley & Sons Inc; 1981:24, 221. 12. Hinderer KH. Diagnosis of anatomic obstructions of the air ways . Arch Otolaryngol. 1963;78:660-663.Crossref 13. Cottle M. Concepts of nasal physiology as related to corrective nasal surgery . Arch Otolaryngol. 1960;72:11-20.Crossref 14. Adamson JE. Constriction of the internal nasal valve in rhinoplasty: treatment and prevention . Ann Plast Surg. 1987;18:114-121.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

Nasal Valve Malfunction Resulting From Resection of Cancer

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References (14)

Publisher
American Medical Association
Copyright
Copyright © 1990 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archotol.1990.01870120065011
Publisher site
See Article on Publisher Site

Abstract

Abstract • Following cancer resection of the nasal unit, nasal valve malfunction is manifested by the symptoms of nasal stuffiness or difficulty getting air into the nostril. These symptoms occur in cases in which the resection is in the alar crease at the junction with the lateral sidewall of the nose. Wound scar contracture elevates the alar margin and causes the alar and lateral cartilages to move inward forming a visible and palpable shelf on the lateral wall of the nasal vestibule. This displacement of the alar and lateral cartilages and the rigid scar formed between these cartilages render the nasal valve immobile. Since it is easier to prevent nasal valve malfunction than to repair it later, wounds that bridge the alar crease or are located in either the alae or lateral sidewall and come within 1 mm of the alar crease with a total diameter of 1.0 cm should be repaired to prevent nasal valve malfunction. In the process of repairing deep defects, the overlapping region of the lateral crus of the alar cartilage and the lateral cartilage may be stabilized by a conchal cartilage graft. This cartilage graft may be used in combination with reconstruction of the nasal skin with a forehead flap and repair of the nasal lining. In the event that the nasal lining is intact, the cartilage graft may be used with a full-thickness skin graft. (Arch Otolaryngol Head Neck Surg. 1990;116:1419-1424) References 1. DeLara Galindo S, Cuspinera E, Ramirez LC. Anatomical and functional account on the lateral nasal cartilages . Acta Anat. 1977;97:393-399.Crossref 2. Zide BM. Nasal anatomy: the muscles and tip sensation . Aesth Plast Surg. 1985;9:193-196.Crossref 3. Stucker FJ, Smith TE. The nasal bony dorsum and cartilaginous vault . Arch Otolaryngol. 1976;102:695-698.Crossref 4. Converse JM. The cartilaginous structure of the nose . Ann Otolaryngol. 1955;64:220-229. 5. Zelnik J, Gingrass RP. Anatomy of the alar cartilage . Plast Reconstr Surg. 1979;64:650.Crossref 6. Sheen J. Aesthetic Rhinoplasty . St Louis, Mo: CV Mosby Co; 1978. 7. Burget GC, Menick FJ. The subunit principle in nasal reconstruction . Plast Reconstr Surg. 1985;76:239.Crossref 8. Burget GC. Aesthetic restoration of the nose . Clin Plast Surg. 1985;12:463-480. 9. Burget GC, Menick FJ. Nasal reconstruction: seeking a fourth dimension . Plast Reconstr Surg. 1986;78:145.Crossref 10. Burget GC, Menick FJ. Nasal support and lining: the marriage of beauty and blood supply . Plast Reconstr Surg. 1989;84:189-203.Crossref 11. Fleiss JL. Statistical Methods for Rates and Proportions . 2nd ed. New York, NY: John Wiley & Sons Inc; 1981:24, 221. 12. Hinderer KH. Diagnosis of anatomic obstructions of the air ways . Arch Otolaryngol. 1963;78:660-663.Crossref 13. Cottle M. Concepts of nasal physiology as related to corrective nasal surgery . Arch Otolaryngol. 1960;72:11-20.Crossref 14. Adamson JE. Constriction of the internal nasal valve in rhinoplasty: treatment and prevention . Ann Plast Surg. 1987;18:114-121.Crossref

Journal

Archives of Otolaryngology - Head & Neck Surgery – American Medical Association

Published: Dec 1, 1990

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