2017-18 HSC Section 4 Green Book

Original Investigation Research

Nasal Valve Obstruction After Rhinoplasty

breathing was similar in the functional and aesthetic- functional groups. Secondary regression analysis was also consistent even when controlling for differences in the reconstruction methods (spreader and alar grafts). Combin- ing aesthetic interventions with functional rhinoplasty did not seem to alter the magnitude of improvement in nasal breathing outcome.

Conclusions Nasal valve reconstruction with spreader and alar grafts is effective in treating patients with NVI. Overall, an improve- ment in the NOSE scale score occurred at the 3-month assessment. The magnitude of improvement in nasal

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ARTICLE INFORMATION Accepted for Publication: October 12, 2015. Published Online: December 10, 2015. doi: 10.1001/jamafacial.2015.1854 . Author Contributions: Drs Hassouneh and Kim had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Kim. Acquisition, analysis, or interpretation of data: All authors. Drafting of the manuscript: All authors. Critical revision of the manuscript for important intellectual content: Hassouneh, Kim. Statistical analysis: All authors. Obtained funding: Kim. Administrative, technical, or material support: Kim. Study supervision: Kim. Conflict of Interest Disclosures: None reported. Funding/Support: This study was supported by a foundation core grant from the American Academy of Otolaryngology–Head and Neck Surgery and by the Leslie Bernstein Investigator Development Grant. Role of the Funder/Sponsor: The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Additional Contributions: The following clinical investigators recruited participants and collected data: Anthony E. Brissett, MD, Baylor Facial Plastic Surgery Center, Houston, Texas; Patrick Byrne, MD, The Johns Hopkins University, Baltimore, Maryland; Randolph Capone, MD, Baltimore Center for Facial Plastic Surgery, Baltimore; Minas Constantinides, MD, NYU (New York University) Langone Medical Center, New York, New York; Peter A. Hilger, MD, University of Minnesota, Minneapolis; David W. Kim, MD, University of California, San Francisco; Ira D. Papel, MD, The Johns Hopkins University; Stephen S. Park, MD, University of Virginia, Charlottesville; Jonathan M. Sykes, MD, University of California, Davis, Sacramento; Travis T. Tollefson, MD, University of California, Davis; Dean Toriumi, MD, University of Illinois at Chicago; and Deborah Watson, MD, University of California, San Diego. Gordon H. Guyatt, MD, MSc, and Diane Heels-Ansdell, MSc, Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada, provided advice with the methods and statistical analysis. None received any compensation for this role. REFERENCES 1 . Chandra RK, Patadia MO, Raviv J. Diagnosis of nasal airway obstruction. Otolaryngol Clin North Am . 2009;42(2):207-225, vii .

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