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Introduction: Internal nasal valve collapse is a troublesome that the Otolaryngology doctors faces in many patients suffering from
inadequate nasal breathing. There are two main suggested reasons for inadequate nasal breathing at the internal nasal valve region;
collapsing alar cartilage and narrow nasal angle. While most of the new literature emphasizes the spreader graft technique, I believe
that flaring technique still plays an important role in management this challenging quest.
Aim: The aim of the present study is to re-evaluate the role of combining alar flare technique to spreader graft in management of
internal nasal valve collapse.
Patients & Methods: 56 patients were included in the present study that underwent different surgical techniques for management of
internal nasal valve collapse. None of the patients had undergone any nasal surgical repair procedure to his or her condition before.
Spreader graft technique have been used alone in 10 patients, while combined alar flare with spreader graft technique was used in 46
patients through an open rhinoplasty approach. The time of surgical procedure, post-operative healing time, subjective scoring of
nasal airway breathing before and after surgery and the degree of nasal dryness were recorded and compared between the two surgical
groups. The post-operative evaluation period ranged from 3 to 5 years.
Results: In the first group of patients who underwent spreader graft technique alone all patients have reported an initial improvement
in nasal airway breathing but only 80% of them have sustained these results after 4 years. In the second group of patients who
underwent a combined alar flare with spreader graft technique, 95.7% of patients have sustained these satisfactory results after 5 years
of surgical procedure.
Conclusion: The combined alar flare with spreader graft technique still provides better results than any of the two surgical techniques
Ahmed Soliman ISMAIL completed his Bachelor of Medicine and Surgery (MBBCh) from Alexandria University, Egypt in 1992 and Master degree in Otorhinolaryngology (MCh ORL) from the same university in 1997. In 2000, he obtained his Fellowship in Plastic and Reconstructive Surgery from Palm Beach Institute of Cosmetic Surgery and Longevity, PBG, Florida, USA. In 2002, he has received a Doctorate degree in Otorhinolaryngology (MD ORL) from Alexandria University, Egypt. In 2005, he received Fellowship training in cranio facial and reconstructive surgery, Columbia University, USA. He has the following Society & organization memberships: Overseas Member of the American Academy of Cosmetic Surgery and Longevity; Member of the Egyptian Society of Otorhinolaryngology Head and Neck Surgery; Member of the Egyptian Society of Plastic and Reconstructive Surgery; Member of the Alexandria Friendship Society of Otorhinolaryngology and Member of the Egyptian Society of Rhinology. He has received many national and international awards. His special interests are Plastic and Reconstructive Surgery of the Head and Neck regions, Otology and Rhinology.