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Alsakka MA, ElBestar M, Gharib FM, El-Antably AS, Al-Sebeih KH. Dorsal preservation rhinoplasty versus dorsal hump reduction: a randomized prospective study, functional and aesthetic outcomes. Eur Arch Otorhinolaryngol 2024; 281:3655-3669. [PMID: 38485745 DOI: 10.1007/s00405-024-08546-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/09/2024] [Indexed: 06/29/2024]
Abstract
PURPOSE To compare the functional and esthetic outcomes of dorsal preservation rhinoplasty (DPR) and conventional dorsal hump reduction (DHR) in primary rhinoplasty using patient-reported outcome measures (PROMs) and cone beam computed tomography (CBCT). METHODS In our randomized prospective double-blinded clinical trial, 50 patients had dorsal nasal hump surgery between October 2021 and November 2022 in our tertiary referral center. All surgeries were done by the same surgeon. Patients were randomly assigned to two groups: Group (A): 25 patients had DPR, and group (B): 25 patients underwent DHR. Pre-operative and post-operative evaluations were conducted using standardized cosmesis and health nasal outcomes survey (SCHNOS), surgeons' rhinoplasty evaluation questionnaire (SREQ), and the CBCT. RESULTS Following an average of 7.22 ± 2.07 months, patients in both groups reported significantly higher levels of satisfaction, as measured by the SCHNOS score (p < 0.001) and the average of three SREQ scores (p < 0.001). These results align with the radiological analysis, which denoted an overall improvement in the average of both sides' internal nasal valve angle and cross-sectional area after surgery with (p = 0.001) and (p = 0.085), respectively, for the DPR group and with (p = 0.281) and (p = 0.014), respectively, for the DHR group. There was no statistically significant difference in outcomes between both groups (p > 0.05). CONCLUSION Dorsal preservation is a viable alternative to conventional dorsal hump reduction in primary rhinoplasty. There was no difference in the functional and esthetic outcomes between both techniques, which were verified by radiological investigation.
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Affiliation(s)
- Mahmoud Abdelaziz Alsakka
- Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Cairo, Egypt.
- Department of Otorhinolaryngology and Facial Plastic Surgery, Canadian Medical Center, Sharqe, Kuwait City, Kuwait.
| | - Mahmoud ElBestar
- Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Fadi Mahmoud Gharib
- Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Adel Said El-Antably
- Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Khalid Hamad Al-Sebeih
- Department of Otorhinolaryngology and Facial Plastic Surgery, Canadian Medical Center, Sharqe, Kuwait City, Kuwait
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Faculty of Medicine, Kuwait University, Jabriya, Hawalli, Kuwait
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Ahn SJ, Park SE, Choi JY, Min JY, Kim KA, Kim SJ. Internal structural analysis of the nasomaxillary complex in patients with skeletal class III asymmetry: A study on asymmetry patterns. Orthod Craniofac Res 2024; 27:376-386. [PMID: 38058275 DOI: 10.1111/ocr.12739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVES To investigate the internal structure of the nasomaxillary complex, including the maxillary sinus, nasal cavity and nasal septum according to the facial asymmetry pattern and to evaluate its correlation with external maxillomandibular asymmetry in Class III patients based on cone-beam computerized tomography (CBCT) images. MATERIALS AND METHODS Facial asymmetry was analysed in a total of 100 Class III patients aged 16 years or older using CBCT scans. Patients were categorized into subgroups based on asymmetry pattern. Measurements of the nasomaxillary complex were obtained from the CBCT scans, including the volume and width of the maxillary sinuses and nasal cavities on deviated and non-deviated sides, as well as the displacement of the nasal septum. Statistical analysis was performed to compare the internal nasomaxillary variables within and between groups, and regression analysis was conducted to evaluate the correlation between facial asymmetry and the internal nasomaxillary variables. RESULTS Group comparisons showed that there were no significant differences in the volume of the maxillary sinus and nasal cavity. However, the direction and extent of nasal septum deviation, as well as the width of the nasal cavity, varied depending on the maxillary asymmetry pattern. Regression analysis indicated a correlation between nasal septum deviation and the difference in maxillary height, while the difference in nasal cavity width was correlated with the difference in maxillary width. CONCLUSION A comprehensive evaluation of the internal nasal anatomy is vital for understanding the intricate relationship between nasal structure and maxillary growth.
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Affiliation(s)
- Sung Jea Ahn
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Korea
| | - Song E Park
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Korea
| | - Jin-Young Choi
- Department of Orthodontics, Kyung Hee University Dental Hospital, Seoul, Korea
| | - Jin Young Min
- Department of Otorhinolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea
| | - Kyung-A Kim
- Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Su-Jung Kim
- Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Korea
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Wu J, Wang X, Chen Y, Zhao H, Qiao Z, Sun Y, Xiong X, Meng X, Li W, Yi Z, Zeng W. Radiographic Study of the Nasal Valve in Different CT Evaluation Method in Asian Patients with Unilateral Cleft Lip Nose. Aesthetic Plast Surg 2024:10.1007/s00266-023-03825-x. [PMID: 38263498 DOI: 10.1007/s00266-023-03825-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/18/2023] [Indexed: 01/25/2024]
Abstract
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 .
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Affiliation(s)
- Jingjing Wu
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, No. 139 Renmin Middle Road, Changsha, 410011, People's Republic of China
| | - Xiancheng Wang
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, No. 139 Renmin Middle Road, Changsha, 410011, People's Republic of China.
| | - Yunzhu Chen
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, No. 139 Renmin Middle Road, Changsha, 410011, People's Republic of China
| | - Hongli Zhao
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, No. 139 Renmin Middle Road, Changsha, 410011, People's Republic of China
| | - Zhihua Qiao
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, No. 139 Renmin Middle Road, Changsha, 410011, People's Republic of China
| | - Yang Sun
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, No. 139 Renmin Middle Road, Changsha, 410011, People's Republic of China
| | - Xiang Xiong
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, No. 139 Renmin Middle Road, Changsha, 410011, People's Republic of China
| | - Xianxi Meng
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, No. 139 Renmin Middle Road, Changsha, 410011, People's Republic of China
| | - Wenbo Li
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, No. 139 Renmin Middle Road, Changsha, 410011, People's Republic of China
| | - Zhongjie Yi
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, No. 139 Renmin Middle Road, Changsha, 410011, People's Republic of China
| | - Weiliang Zeng
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, No. 139 Renmin Middle Road, Changsha, 410011, People's Republic of China
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Koplay TG, Inan I, Ozer H. Comparison of the Effects of Spreader Graft Versus Spreader Flap on Nasal Valve Angle in Open Approach Rhinoplasty. Aesthetic Plast Surg 2023; 47:2625-2631. [PMID: 37640816 DOI: 10.1007/s00266-023-03598-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/07/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE This study aimed to compare the spreader graft and flap techniques, which are used in nasal valve surgery, based on measurements of nasal valve angles using computed tomography. MATERIAL AND METHOD In this retrospective study, all patients' right and left internal nasal valve angles were measured from coronal computed tomography images taken preoperatively and in the third postoperative month. A paired t-test and independent t-test were used to compare continuous numerical variables. RESULTS There were 52 patients with 104 valves in the spreader flap group and 54 patients with 108 valves in the spreader graft group, with a mean age of 27.76 ± 8.16 years. The angles were found to be statistically significantly higher in the postoperative period (p<0.001) in all patients. While the angles did not differ significantly between the flap and graft groups in the preoperative period, they were significantly higher in the flap group in the postoperative period (p<0.001). DISCUSSION It is essential to preserve nasal valve function in rhinoplasty. The findings show that a spreader flap is superior to a spreader graft, although both techniques increase internal nasal valve function. LEVEL OF EVIDENCE III 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 .
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Affiliation(s)
- Tugba Gun Koplay
- Department of Plastic Reconstructive and Aesthetic Surgery, Konya City Hospital, Konya, Turkey.
| | - Irfan Inan
- Plastic, Reconstructive and Aesthetic Surgery, Private Clinic, Konya, Turkey
| | - Halil Ozer
- Medical Faculty, Department of Radiology, Selcuk University, Konya, Turkey
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McIntosh C, Stutterheim J, Prinsloo H, Randall M, Toman J, Pisapia F. The RhinoCEROS Guidelines: A Practical Tool for Reporting Nasal Anatomy on Computed Tomography Pertaining to Rhinoplasty. Facial Plast Surg 2023. [PMID: 36596465 DOI: 10.1055/a-2006-0916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Cone-beam computed tomography (CT) is gaining popularity worldwide due to an increasingly diffuse and affordable in-office availability. It is becoming more commonplace for rhinoplasty surgeons to utilize this imaging as tool for preoperative assessment; however, there is inconsistency among radiologists commenting on specific structures of the nose or nasal cavity as there is currently no standardized reporting protocol. The goal of this article is to present clear guidelines for radiologists to report relevant nasal anatomy in the context of preoperative rhinoplasty evaluation. We have proposed the RhinoCEROS Guidelines, which stands for: Rhinoplasty Cephalometric Evaluation for Radiologic pre-Operative Systematization. This guideline highlights the primary aspects of nasal anatomy on CT that affect rhinoplasty outcomes and will provide radiologists with a straightforward template for reporting this increasingly popular use for CT scan.
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Affiliation(s)
| | | | | | - Michael Randall
- Department of Otolaryngology Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Morsani College of Medicine, University of South Florida, Florida, USA
| | - Julia Toman
- Department of Otolaryngology Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Morsani College of Medicine, University of South Florida, Florida, USA
| | - Francesco Pisapia
- Department of Maxillofacial sciences, La Sapienza Universitá di Roma, Roma, Italy
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Waters CM, Stepp WH, Conduff J, Balakrishnan S, Bu R, Oldenburg AL, Kimbell JS, Shockley WW, Clark JM. Anatomic Optical Coherence Tomography (aOCT) for Evaluation of the Internal Nasal Valve. Laryngoscope 2022; 132:2148-2156. [PMID: 34894356 PMCID: PMC9187776 DOI: 10.1002/lary.29979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/29/2021] [Accepted: 11/29/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS To establish the utility of anatomic optical coherence tomography (aOCT) in evaluating internal nasal valve (INV). STUDY DESIGN Anatomic specimen imaging study. METHODS Fresh-harvested human specimen heads were evaluated using both computed tomography (CT) imaging as well as using aOCT. Scans were performed at three time points: 1) After septoplasty for cartilage harvest, 2) after placement of butterfly graft (BFG), and 3) after placement of bilateral spreader grafts (SG). Imaging data were then converted into 3D models of the nasal airway. CT- and aOCT-generated models were compared by both static volumetric analysis and computational fluid dynamics (CFD) to predict nasal resistance and pressure. RESULTS Scans using aOCT showed comparable results to CT in terms of volumetric parameters both before and after intervention. Analysis of aOCT data by CFD demonstrated decrease in pressure after SG or BFG intervention. No statistically significant difference was observed when comparing CT- and aOCT-generated calculations of pressure or resistance. CONCLUSION The INV can be imaged in a static fashion using aOCT technology. Advantages over traditional CT imaging include lack of exposure to radiation and rapid scan time. In addition, in-office use is possible as aOCT technology develops. Further investigation will be necessary to define the role of aOCT in the dynamic evaluation of this vital component of the nasal airway. LEVEL OF EVIDENCE 3 Laryngoscope, 132:2148-2156, 2022.
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Affiliation(s)
- Candace M. Waters
- 1) University of North Carolina at Chapel Hill, Department of Otolaryngology/Head & Neck Surgery, Chapel Hill, NC
- 2) Wake Forest Baptist Medical Center, Department of Otolaryngology/Head & Neck Surgery, Winston-Salem, NC
| | - Wesley H. Stepp
- 1) University of North Carolina at Chapel Hill, Department of Otolaryngology/Head & Neck Surgery, Chapel Hill, NC
| | - Joseph Conduff
- 1) University of North Carolina at Chapel Hill, Department of Otolaryngology/Head & Neck Surgery, Chapel Hill, NC
| | - Santosh Balakrishnan
- 3) University of North Carolina at Chapel Hill, Department of Physics, Chapel Hill, NC
| | - Ruofei Bu
- 3) University of North Carolina at Chapel Hill, Department of Physics, Chapel Hill, NC
| | - Amy L. Oldenburg
- 3) University of North Carolina at Chapel Hill, Department of Physics, Chapel Hill, NC
| | - Julia S. Kimbell
- 1) University of North Carolina at Chapel Hill, Department of Otolaryngology/Head & Neck Surgery, Chapel Hill, NC
| | - William W. Shockley
- 1) University of North Carolina at Chapel Hill, Department of Otolaryngology/Head & Neck Surgery, Chapel Hill, NC
| | - J. Madison Clark
- 1) University of North Carolina at Chapel Hill, Department of Otolaryngology/Head & Neck Surgery, Chapel Hill, NC
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Harounian JA, Yu D, Lu X, Friedman O. Variation in Practice Patterns of Current Rhinoplasty Surgeons for Nasal Valve Compromise. Facial Plast Surg Aesthet Med 2021. [PMID: 34495760 DOI: 10.1089/fpsam.2021.0114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: To compare practice patterns of rhinoplasty surgeons with the 2010 clinical consensus statements (CCSs) on nasal valve compromise (NVC) and delineate what variables may affect such practice patterns and consensus. Methods: An online questionnaire pertaining to the 2010 CCS was administered at the Advances in Rhinoplasty meeting with responses based on a 9-point Likert scale. Results: Of 580 participants, 113 completed the survey with the majority of statements in accordance between panelists and surveyors. Less than 10% of responses met discordance criteria. Significant differences in practice patterns exist when stratified by specialty, years-in-practice, geographic location, type of practice, and annual number of rhinoplasties performed. Conclusion: There is a general concordance between practice patterns of active rhinoplasty surgeons and the 2010 CCS on NVC despite a decade of new studies in the interim. Significant differences, however, exist regarding the utility of diagnostic imaging, rhinoscopy, nasal endoscopy, and acoustic rhinomanometry in the evaluation of NVC. Furthermore, variables such as specialty, years in practice, annual number of rhinoplasties performed, practice setting, and geographic location significantly affect these perspectives and overall consensus.
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Affiliation(s)
- Jonathan A Harounian
- Department of Otolaryngology-Head and Neck Surgery, Temple University Hospital, Philadelphia, Pennsylvania, USA
| | - Daohai Yu
- Department of Clinical Sciences, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Xiaoning Lu
- Department of Clinical Sciences, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Oren Friedman
- Facial Plastic Surgery, Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Kimura S, Suzuki M, Honma A, Nakazono A, Osawa M, Nakamaru Y, Homma A. Objective evaluation of caudal deviation of the nasal septum and selection of the appropriate septoplasty technique. Auris Nasus Larynx 2021; 49:67-76. [PMID: 33966932 DOI: 10.1016/j.anl.2021.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 03/16/2021] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Several methods have been reported to correct caudal deviation of the nasal septum, including open septorhinoplasty (OSR) and septoplasty with Killian incision (KI). In general, OSR is applied instead of KI for caudal deviation. However, there is little objective evidence own on the effects of OSR and KI for caudal deviation. In this study, we compared surgical outcomes between OSR and KI by quantifying nasal septum deviation using two simple and objective parameters on routine paranasal sinus CT scans. METHODS We retrospectively analyzed 18 patients who underwent OSR and 11 patients who underwent septoplasty with KI between April 2006 and October 2019. Caudal deviation was defined on the basis of the "Anterior-posterior Position of the most deviated point of the nasal septum (AP)," which was measured on computerized tomography. The deformation rate (DR) of the nasal septum was also calculated. Nasal airway resistance and visual analogue scale (VAS) score for nasal obstruction were examined. RESULTS The AP was significantly correlated with the VAS score (r=-0.58, p=0.017). The DR in patients with caudal septal deviation was significantly decreased by OSR (0.14±0.06 to 0.03±0.03, p=0.004), but not by KI (0.09±0.08 to 0.04±0.03, p=0.25). OSR also improved nasal airway resistance (1.10±0.44 to 0.42±0.15, p=0.02), and the VAS score (79.11±14.74 to 5.78±7.89, p=0.004). CONCLUSION Nasal obstruction is more severe in patients with the caudal deviation. OSR corrects caudal deviation of the nasal septum more effectively than does KI. The AP could be useful for the evaluation of the deviation of the nasal septum and help in selecting the appropriate septoplastic technique.
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Affiliation(s)
- Shogo Kimura
- Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Masanobu Suzuki
- Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Aya Honma
- Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Akira Nakazono
- Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Masayuki Osawa
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yuji Nakamaru
- Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan.
| | - Akihiro Homma
- Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
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Hosseini S, Schuman TA, Walenga R, Wilkins JV, Babiskin A, Golshahi L. Use of anatomically-accurate 3-dimensional nasal airway models of adult human subjects in a novel methodology to identify and evaluate the internal nasal valve. Comput Biol Med 2020; 123:103896. [PMID: 32768043 DOI: 10.1016/j.compbiomed.2020.103896] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 06/17/2020] [Accepted: 06/27/2020] [Indexed: 11/15/2022]
Abstract
The optimal method for radiographic evaluation of the internal nasal valve (INV) has not been established. The objective of this study was to develop a method to assess the cross-sectional area and the angle of the INV using anatomically-accurate 3D digital nasal airway models. Axial CT images of the paranasal sinuses of twenty adult subjects with healthy nasal airways (50% female and 50% age ≥ 50) were used to create the models. Patients with significant radiographic evidence of sinonasal disease were excluded. A primary cutting plane that passed through the edge of the nasal bone, upper lateral cartilage, and the head of the inferior turbinate was defined in coronal view. This primary coronal cutting plane was then rotated in 5° increments anteriorly while ensuring the anatomic criteria for the INV were still met. The cutting plane resulting in the minimum INV area was identified as the optimal cutting plane and the total cross-sectional area of INV in this plane,198.79 ± 54.57 mm2, was significantly less than the areas obtained using the existing methods for radiographic evaluation of the INV. The angle between the optimal cutting plane and nasal dorsum was 75.00 ± 10.26°, and the corresponding INV angle was 10.77 ± 6.02°.
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Affiliation(s)
- Sana Hosseini
- Department of Mechanical and Nuclear Engineering, VCU, Richmond, VA, USA
| | - Theodore A Schuman
- Department of Otolaryngology- Head and Neck Surgery, VCU Health, Richmond, VA, USA
| | - Ross Walenga
- Division of Quantitative Methods and Modeling, Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - John V Wilkins
- Department of Mechanical and Nuclear Engineering, VCU, Richmond, VA, USA
| | - Andrew Babiskin
- Division of Quantitative Methods and Modeling, Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Laleh Golshahi
- Department of Mechanical and Nuclear Engineering, VCU, Richmond, VA, USA.
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