A reprodutibilidade do espelho de Glatzel modificado na aferição da permeabilidade nasal

Comparison of the Effect of Spreader and T-Splay Graft in Internal Nasal Valve Management

BACKGROUND

The midvalve area is one of the most important anatomical points in rhinoplasty procedures. An additional intervention may be required to ensure there is no narrowing in this region. For this reason, several different techniques are used. Spreader graft technique is the most common of all these methods. T-splay graft technique is an alternative method that can effectively widen the angle of the midvalve. The present study compares the anatomical and functional outcomes of these two methods.

METHODS

The study included 60 cases who presented to our clinic for rhinoplasty. The cases were evaluated demographically, anatomically, and functionally, and the acquired data were recorded. All cases were preoperatively administered the Visual Analogue Scale, the Nasal Obstruction Symptom Evaluation scale, and the modified Glatzel mirror test. By randomly selecting the cases, midvalve restoration was performed with a spreader graft in 30 cases and a T-splay graft in 30 cases.

RESULTS

A comparison of the Visual Analogue Scale, the Nasal Obstruction Symptom Evaluation scale, and the modified Glatzel mirror test scores revealed that the scores of both groups at postoperative months 3 and 6 were significantly different from the preoperative measurement values.

CONCLUSIONS

Although spreader graft technique is a very effective method in midvalve management, we believe that T-splay graft technique may also produce effective outcomes. In addition, the midvalve functions could be better simulated anatomically and functionally with T-splay graft technique. Therefore, we believe that T-splay graft technique is an alternative method that can be safely used in selected cases.

LEVEL OF EVIDENCE III

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Adult tonsillectomy: anatomical differences affect postoperative transient hypernasality

OBJECTIVE

Our purpose was to determine how anatomical conditions of the throat influence the degree and duration of posttonsillectomy transient hypernasality.

PATIENTS AND METHODS

A total of 82 tonsillectomies were performed. The participants were divided into groups: 1 – small tonsils, high soft palate position; 4 – large tonsils, low soft palate position, and 2 and 3 – intermediate tonsil dimensions and soft palate positions. Variables studied included the diameter of vapor (DV) on the mirror positioned under the patient's nose while articulating nasal sentences before and after surgery, the distance from the uvular tip to the posterior pharyngeal wall, healing grading as well as the degree and duration of hypernasality.

RESULTS

The mean hypernasality after tonsillectomy was greatest in group 4 and lowest in group 2. Before tonsillectomy, the mean DV was largest in group 2 and smallest in group 4. After tonsillectomy, the mean DV was largest in group 4 and smallest in group 3. Overall, the mean DV was significantly greater after tonsillectomy compared to the value before surgery.

CONCLUSION

The degree of hypernasality after tonsillectomy depends on the soft palate position in relation to the tongue base and the size of the tonsils. Hypernasality is greatest in patients with large tonsils and a low soft palate position in relation to the tongue base.

Avaliação do respirador oral: uso do espelho de Glatzel e do peak nasal inspiratory flow

OBJETIVO: Comparar o uso do espelho de Glatzel e do peak nasal inspiratory flow na avaliação de indivíduos respiradores orais, bem como analisar a correlação dos dois instrumentos. MÉTODOS: Foram avaliadas 64 crianças, sendo 32 respiradoras orais e 32 respiradoras nasais, na faixa etária de 4 a 12 anos. Os respiradores orais, diagnosticados de acordo com equipe multiprofissional, foram subdivididos de acordo com a causa da obstrução. Foram utilizados o espelho de Glatzel e o peak nasal inspiratory flow nos dois grupos para avaliação da permeabilidade e fluxo aéreo nasal. Os dados foram submetidos à análise estatística. RESULTADOS: O espelho de Glatzel diferenciou o modo respiratório considerando-se os estratos gênero, faixa etária, peso, altura e índice de massa corporal da amostra. Entretanto, não foi capaz de dar indícios sobre a causa da respiração oral. Com o uso do peak nasal inspiratory flow, não foi possível diferenciar o modo respiratório e tampouco a causa da respiração oral. Na amostra pesquisada, não houve correlação entre os instrumentos utilizados. CONCLUSÃO: O espelho de Glatzel mostrou ser capaz de identificar indivíduos com e sem obstrução nasal, embora não tenha sido possível diferenciar os subgrupos de respiradores orais entre si com o uso do instrumento. Já o peak nasal inspiratory flow mostrou-se capaz de diferenciar apenas respiradores nasais de respiradores orais cirúrgicos. Foi encontrada baixa correlação entre os dois instrumentos.