Get access

Axial computed tomography evaluation of the internal nasal valve correlates with clinical valve narrowing and patient complaint

Authors

  • Jason A. Moche MD,

    1. Department of Otolaryngology-Head and Neck Surgery, Columbia University College of Physicians and Surgeons, New York, NY
    Search for more papers by this author
  • Justin C. Cohen MD,

    Corresponding author
    1. Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College, New York, NY
    • Department of Otolaryngology-Head and Neck Surgery, Columbia University College of Physicians and Surgeons, New York, NY
    Search for more papers by this author
  • Steven J. Pearlman MD

    1. Department of Otolaryngology-Head and Neck Surgery, Columbia University College of Physicians and Surgeons, New York, NY
    Search for more papers by this author

  • Potential conflict of interest: None provided.

  • Presented in part at the annual meeting of the American Academy of Facial Plastic and Reconstructive Surgeons, Boston, MA, 2010.

Correspondence to: Justin C. Cohen, MD, 180 Fort Washington Ave., Rm. HP 8–814, New York, NY 10032; e-mail: juc9053@nyp.org

Abstract

Background

The objective of this work was to explore the utility of axial computed tomography (CT) imaging to objectively define a narrow internal nasal valve, and compare those findings with clinical examination and patient complaint.

Methods

Retrospective review from a single facial plastic surgery center. We reviewed 40 consecutive patients evaluated for either sinusitis or nasal airway obstruction for which a CT scan was obtained at a single radiology institution. Thirty-six complete office records were examined for the presence of clinical internal valve narrowing and complaints of nasal obstruction. In total, 72 internal nasal valves were analyzed using axial plane CT and measurements were compared to clinical findings and presence of airway obstruction.

Results

Measured valve areas for clinically normal internal nasal valves averaged 0.47 cm2 vs 0.28 cm2 for clinically narrow valves, a decrease of 40.4%. In unobstructed nasal airways the valve area averaged 0.51 cm2 vs 0.38 cm2 in obstructed airways, a difference of 25.5%. A radiographically measured valve area of <0.30 cm2 suggests clinical narrowing with a sensitivity of 71.4%, specificity of 88.9%, positive predictive value of 62.5%, and negative predictive value of 92.3%.

Conclusion

Using standard axial CT imaging we describe an objective method of radiographically evaluating the nasal valve, demonstrating strong correlation with physical examination and patient complaint. Additionally, radiographic valve areas can be used to screen for clinically narrow nasal valves with good sensitivity and specificity, providing a novel straightforward method for nasal valve assessment.

Get access to the full text of this article

Ancillary