Author Affiliation: Department of Otolaryngology–Head and Neck Surgery, Rush University, Chicago, Illinois.
I thank Dr Xavier for his insight regarding “Anatomical Comparison of Minimally Invasive Nasal Valve Procedures.” The points he raises are valid, and it is a very good question as to the exact mechanism whereby the internal nasal valve surface area is increased. Albeit a theoretical question, some insight may be gained by reviewing a 2008 article by Dutton and Neidich.1 This article shows that patients feel subjective improvement in nasal airflow after Z-plasty; this outcome suggests that the “decrease in stiffness of the middle third of the nose” may be minimal.
Weeks DM. Internal Nasal Valve Functional Surgery—Reply. Arch Facial Plast Surg. 2012;14(6):465-468. doi:10.1001/2013.jamafacial.128