External Nasal Valve Efficacy Index: a simple test to evaluate the external nasal valve

Bohluli, Behnam; Varedi, Payam; Kahali, Roozbeh; Bagheri, Shahrokh C.

doi:10.1016/j.ijom.2015.05.007

Cited by 7 publications

(7 citation statements)

References 8 publications

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“…Considering the significant increase of ENVE index at the postoperative period, the maxillary impaction's negative effect on ENVE index may be masked by maxillary advancement. In patients who will undergo rhinoplasty with an ENVE index of less than 1, a reductive procedure such as cephalic shaving on the components of the external nasal valves was not recommended 7 . In a previous case report, the ENVE index was close to 0 in 2 patients, so an external crus support graft and an alar contouring graft were placed for strengthening of the components forming the external nasal valve.…”

Section: Discussionmentioning

confidence: 99%

“…In a previous case report, the ENVE index was close to 0 in 2 patients, so an external crus support graft and an alar contouring graft were placed for strengthening of the components forming the external nasal valve. External nasal valve efficiency index has not been evaluated after orthognathic surgery, other than 1 case report 7 . This patient with low ENVE index was scheduled for orthognathic surgery and secondary rhinoplasty.…”

Section: Discussionmentioning

confidence: 99%

“…The external nasal valve efficiency (ENVE) index, which can be easily replicated and documented, is another method for simple photography evaluating the ENVE. For the calculation of this index, the patient's total nostril area in deep inspiration is divided by the total nostril area at the resting position 7 …”

mentioning

confidence: 99%

“…For the calculation of this index, the patient's total nostril area in deep inspiration is divided by the total nostril area at the resting position. 7 Because Le Fort I osteotomy is related to the structures forming the external nasal valve and having changes on the nose such as alar flaring, movements of the maxilla may affect the external nasal valve function. 8,9 For this reason, it is essential to clarify the positive and negative effects of Le Fort I osteotomy on the ENVE before surgery.…”

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confidence: 99%

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The Assessment of External Nasal Valve Efficiency After Le Fort I Surgery

Dilaver,

Suzen,

Seyidoglu

et al. 2023

Ann Plast Surg

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Background The present study investigated how external nasal valve function is affected after Le Fort I osteotomy using external nasal valve efficiency (ENVE) index. Materials and Methods Twenty-one patients who underwent Le Fort I osteotomy with or without mandibular osteotomy were included in the retrospective study. Preoperative and postoperative standardized videos of basal view of the nose during breathing were recorded, and 2 screenshots were taken, 1 in the resting position and the other after deep inspiration. External nasal valve efficiency was calculated at preoperative and postoperative periods for each patient. Results Of the 21 patients, 12 were women and 9 were men (mean age, 26.63 ± 8.20 years). The mean ENVE index was 0.75 ± 0.16 for the preoperative period and 0.82 ± 0.17 for the postoperative period. There was a significant difference between these values (P = 0.002). When the correlation of the ENVE with maxillary movements was analyzed, the ENVE was negatively affected by maxillary impaction (P = 0.011, r = −0.540). Conclusions These findings imply that Le Fort I osteotomy positively affects the ENVE index. However, because of the antagonistic relation between maxillary impaction and ENVE, higher maxillary impaction amounts or isolated maxillary impaction should be carefully planned in patients with low ENVE index.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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The Assessment of External Nasal Valve Efficiency After Le Fort I Surgery

Dilaver,

Suzen,

Seyidoglu

et al. 2023

Ann Plast Surg

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“…Examples of objective tests used to assess nasal function include rhinomanometry, acoustic rhinometry, rhinoresiliography, ENV efficacy index, computational fluid dynamics, and radiology [1,3,4,[20][21][22][23]. Anterior active rhinomanometry is the most common, generally used in the clinical setting, to calculate nasal airway resistance during the respiratory cycle through measuring airflow as a function of air pressure for each nasal cavity [24,25].…”

Section: Diagnosismentioning

confidence: 99%

Nasal Obstruction and Rhinoplasty: A Focused Literature Review

Wright¹,

Grunzweig

Totonchi

2020

Aesth Plast Surg

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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.

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