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Cited by 28Nasal Surgery and Airway StudiesCleft Lip and Palate ResearchSinusitis and nasal conditions

Nasal Obstruction and Rhinoplasty: A Focused Literature Review

Wright, Lauren, Grunzweig, Katherine A., Totonchi, Ali·2020·Aesthetic Plastic Surgery
DOI 10.1007/s00266-020-01710-5
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Abstract

Background There is a significant variation in the assessment, treatment, and outcomes of nasal airway obstruction and management in the published literature. This study aimed to: (1) define key components of the nasal airway, (2) identify frequent causes of nasal obstruction, and (3) review existing treatment methods.Methods A systematic review of the literature was performed, and 135 studies were included via the following criteria: English, human subjects, and a primary endpoint of nasal airway improvement. Exclusion criteria were: abstract only, no airway data, pediatric patients, cleft rhinoplasty, sleep apnea, isolated traumatic nasal reconstruction, and cadaveric-only or animal studies.Results The relevant obstructive sites include the ENV, septum, inferior turbinates, INV, and nasal bones. Addressing the alar rim alone may be insufficient, and inspection of the lateral wall and crura may be indicated. Correction of septal deviation involves attention to the bony base. Mucosal sparing treatment of inferior turbinates improves outcomes. INVs are a major source of nasal obstruction, and treatment includes spreader grafts. The bony nasal vault can contribute to nasal obstruction, including due to surgical osteotomies.Conclusions Anatomic causes of airway obstruction include the alar rims and lateral nasal walls, deviated nasal septum, inferior turbinate hypertrophy, decreased INV angle, and narrowed nasal bones. Treatments include graft placement; septoplasty; mucosal sparing turbinectomy; and lateral wall support. Pitfalls include failing to address the bony septum, over-resection of inferior turbinates, and narrowing of the nasal vault. Appreciation of airway management during rhinoplasty will improve functional outcomes.Level of evidence v 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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Crossref · 10.1007/s00266-020-01710-5

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136 of 136 references verified0 citation errors · 0 not checkable

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  • Deviations of the caudal septum can compromise nasal airflow.

    “Deviations of the caudal septum can compromise nasal airflow.”

    From Sliding Spine Relocation Surgery with Anterior Septal Reconstruction (2024) · cites this paper as [5]

  • Static external nasal valve obstruction can result from deviated caudal septum and anterior nasal spine encroachment.

    “Static obstruction results from a narrowed nostril as in stenosis of the pyriform aperture, deviated caudal septum, anterior nasal spine (ANS) encroachment, and post-surgical vestibular skin cicatricial stenosis.4,5”

    From Sliding Spine Relocation Surgery with Anterior Septal Reconstruction (2024) · cites this paper as [5]

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Authors
Wright, L., Grunzweig, K. A., & Totonchi, A.
Affiliations
  • University Hospitals Cleveland Medical Center (US)
  • MetroHealth (US)
Corresponding author
Totonchi, Ali
ORCID
Venue
Aesthetic Plastic Surgery
Publisher
Springer Science and Business Media LLC
Published
2020-04-23
Volume
44
Issue
5
Pages
1658-1669
ISSN
  • 0364-216X (ISSN-L)
  • 1432-5241
DOI
10.1007/s00266-020-01710-5
OpenAlex
W3020001190
Cited by
28
References
136
Citations by year
2026: 6 · 2025: 7 · 2024: 5 · 2023: 2 · 2022: 3 · 2021: 5
FWCI
0.57
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Aesthetic Plastic Surgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Cleft Lip and Palate Research
  • Health Sciences › Medicine › Otorhinolaryngology › Sinusitis and nasal conditions
Keywords
nasal obstruction, rhinoplasty, septal deviation, inferior turbinate hypertrophy, nasal bone, septoplasty, spreader grafts, nasal osteotomy, lateral nasal wall
MeSH terms
Child, Humans, Nasal Septum, Rhinoplasty, Turbinates, Nasal Obstruction, Treatment Outcome

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