An International Journal Clinical Rhinology

Register      Login

VOLUME 2 , ISSUE 3 ( September-December, 2009 ) > List of Articles

RESEARCH ARTICLE

Alar Batten Grafts for Non-iatrogenic Nasal Valve Area/Alar Collapse

C Ekambar E Reddy, Trevor Teemul, Sucha Hampal, Krishna TV Reddy

Keywords : Rhinoplasty,nasal valve collapse,cartilage graft

Citation Information : Reddy CE, Teemul T, Hampal S, Reddy KT. Alar Batten Grafts for Non-iatrogenic Nasal Valve Area/Alar Collapse. Clin Rhinol An Int J 2009; 2 (3):1-4.

DOI: 10.5005/jp-journals-10013-1001

Published Online: 01-12-2009

Copyright Statement:  Copyright © 2009; The Author(s).


Abstract

Objectives

We present our 3 years experience with alar batten grafts, using a modified technique, for non-iatrogenic nasal valve/alar collapse.

Methods

Retrospective (Oct. 2005 to Apr. 2008) and prospective study (Apr. 2008 to Dec. 2008) of 16 consecutive patients undergoing alar batten grafts for alar collapse causing nasal obstruction. The graft was inserted through a rim incision and placed across as well as superficial to the lower lateral cartilage. The main outcome measures were subjective improvement in nasal obstruction and absence of alar collapse at examination.

Results

Alar collapse was bilateral (n = 8), right sided (n = 4) and left sided (n = 4) giving 24 operated sides (s = 24). Deviated nasal septum (n = 9), synechiae (n = 1) and drooping tip (n = 1) were also present. Donor sites for the graft were septal cartilage (n = 10), conchal cartilage (n = 4) or both septal and conchal cartilages (n = 2). The median follow-up was 4 months (range 1 month to 3 years). Subjective nasal obstruction had worsened in 0%, was unchanged in 16.6% (s = 4), had improved in 16.6% (s = 4) and 66.6% (s = 16) were completely free of obstruction. Two of the improved cases worsened at 10 and 3 years giving overall failure in 25% (s = 6). Significant alar collapse was present in all failed cases and absence of collapse was documented in improved cases (s = 13). In failed cases the graft size width was 5 to 8 mm and in successful cases it was 10 to 15 mm. Lengths of the grafts in all cases was between 18 and 24 mm. One complication of graft extrusion through skin occurred.

Conclusion

Our technique of alar batten graft insertion appears to be as effective as other techniques described in the literature. We suggest a minimum graft size of 10 mm width and 18 mm length to improve success rate.


PDF Share
  1. The treatment of nasal valve obstruction. Plast Reconstr Surg 1994;93:1174-82.
  2. The relative importance of septal and nasal valvular surgery in correcting airway obstruction in primary and secondary rhinoplasty. Plast Reconstr Surg 1996;98:38-54.
  3. Nasal valve collapse. Ear Nose Throat J 2004;83:163-64.
  4. Alar batten grafting for management of the collapsed nasal valve. Laryngoscope 2002;112:574-79.
  5. The diagnosis and treatment of nasal valve collapse. Curr Opin Otolaryngol Head Neck Surg 2008;16:10-13.
  6. Use of alar batten grafts for correction of nasal valve collapse. Arch Otolaryngol Head Neck Surg 1997;123:802-08.
  7. Nasal reconstruction with conchal cartilage: Correcting nasal valve and lateral nasal collapse. Arch Otolaryngol Head-Neck Surg 1994;120:653-8.
  8. Treatment of nasal obstruction from nasal valve collapse with alar batten grafts. J Long Term Eff Med Implants 2003;13:259-69.
  9. Surgery of the incompetent nasal valve. Laryngoscope 1985;95:546-55.
  10. Functional rhinoplasty: Treatment of dysfunctional nasal sidewall. Facial Plast Surg 2006;22:49-54.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.