Strategy of care delivery in patients with nasal valve dysfunction

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Andrei Makaryn-Kibak and Zhanna Kaliadzich

Scientific and Practical Center of Otolaryngology of the Republic of Belarus, Belarus
State Institution «N.N. Alexandrov Scientific and Practical Center of Oncology and Medical Radiology» of the Republic of Belarus, Belarus

: J Otol Rhinol

Abstract

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The nasal valve is a complex three-dimensional structure consisting of several morphological structures. From the physiological point of view, this is the place of greatest resistance to the flow of air passing through the cavity. Thus, in accordance with Poiseuille's law, even minor narrowing of this area leads to a clinically significant disturbance of the patient's nasal breathing. The etiology of the nasal valve dysfunction is versatile, making it necessary to develop an individual treatment algorithm for patients with impaired nasal breathing. The conducted research allowed us to formulate an algorithm for helping patients with nasal valve dysfunction, which is based on data on the effectiveness of various treatment methods in the main types of pathology, as well as consideration of additional factors, such as operations and the shape of the external nose. To determine the risk factors of the nasal valve dysfunction, we examined and questioned 482 patients with complaints of obstructed nasal breathing. All the patients underwent computed tomography, endoscopy of the nasal cavity, as well as a set of rhinometry studies (acoustic rhinometry, anterior active rhinomanometry, rhinoresistometry) in accordance with the recommendations of the international consensus. In 86 patients nasal valve dysfunction was detected (17.8%). By means of statistical data processing, factors that are predictors of nasal valve dysfunction were identified, which allows screening patients without the need for extensive implementation of costly procedures (CT, acoustic rhinometry). Based on the data obtained, a mathematical prediction program and a complex diagnostic algorithm were developed. Considering the data of mathematical prediction, a complex personified approach of nasal valve dysfunction treatment was developed taking into account the level (levels) of narrowing. This allowed to justify the choice of treatment tactics, minimizes the unjustified choice of the surgical treatment method.

Biography

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Andrei Makaryn-Kibak works as an ENT Surgeon in the Department for Adults in the Scientific and Practical Center of Otolaryngology of the Republic of Belarus for 6 years. His interests include nasal breathing difficulties, nasal valve, nasal cycle, FESS, hearing improvement and reconstruction surgery for the middle and inner ear, balloon dilation of the Eustachian tube.

E-mail: andrew.makarin.kibak@gmail.com