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"ABSTRACTAlar defects generally mandate replacement of the entire unit. The nasal alar unit is highly contoured, has a free margin, and contributes to the external nasal valve. Many methods exist to reconstruct the ala, including local nasal flaps, skin grafts, composite auricular grafts, and pedicle flaps. In most instances, however, consistent results require a cartilage subsurface framework to resist the forces of contraction and provide a stable external valve and provide a scaffold for contour Main Outcome Measures Observer's and patient's rating of the final results, patient's rating of breathing and level of self-consciousness, and medical record review of complications. Most aesthetic outcomes were excellent to good. Breathing from the reconstructed side can be returned to preoperative status in most of these patients. Staged reconstruction of the nasal ala using free cartilage grafts, interpolated cheek or forehead and mucosal flaps when necessary, result in a highly aesthetic and functional outcome in most patients. "

"Penelitian ini bertujuan untuk mengetahui efektivitas NNP dan Mini FESS sebagai modalitas terapi pasien hidung tersumbat dengan SDB. Digunakan rancangan pre eksperimental sebelum dan sesudah NNP dan Mini FESS dengan menilai perubahan pemeriksaan kualitatif menggunakan Epworth Sleepiness Scale (ESS), Skor Analog Visual (SAV), Peak Nasal Inspiratory Flow (PNIF), nasoendoskopi dan Polisomnografi (PSG). Pengambilan subyek penelitian secara berurutan (consecutive sampling) selama 6 bulan di poli THT-RSCM. Sebanyak 7 pasien dengan keluhan hidung tersumbat disertai sleep disordered breathing menunjukkan perbaikan pasca operasi berdasarkan ESS dengan delta 48,28±1,99% nilai p=0,017, SAV median delta 100%(80% - 100%) nilai p=0,018, PNIF delta 52,03±2,69% p=0.017 dan 85,71% (6 dari 7) perbaikan ukuran konka inferior menjadi normal. Seluruh parameter PSG tidak didapatkan adanya perubahan yang bermakna dengan p>0,05. NNP dan mini FESS efektif untuk mengatasi hidung tersumbat yang disertai SDB berdasarkan perbaikan parameter pemeriksaan kualitatif. Hipereaktifitas parasimpatis yang mengakibatkan hipertrofi konka inferior merupakan hipotesis yang dapat dibuktikan pada penelitian ini dan memperkaya kerangka teori pada patofisiologi obstruksi nasal sebagai penyebab SDB.

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This study aims to determine the effectiveness of PNN and Mini FESS as a therapeutic modality for patients with nasal congestion and SDB. This pre- experimental study evaluated the efficacy of PNN and mini FESS in management of nasal obstruction with SDB subjects. The evaluation performed by assessing changes in qualitative examination using Epworth Sleepiness Scale (ESS), Visual Analog Score (VAS) of nasal obstruction symptom Peak Nasal Inspiratory Flow (PNIF), nasoendoscopic examination. and Polysomnography (PSG). The subjects were included consecutively for 6 months at ENT clinic-Cipto Mangunkusumo Hospital. A total of 7 patients with nasal obstruction and sleep disordered breathing showed post-operative improvement in evaluations by using ESS (delta 48.28 ± 1.99% p-value = 0.017), VAS of nasal obstruction with median delta of 100 % ( 80 % - 100 % ) and p-value = 0.018, PNIF (delta 52.03 ± 2.69% p-value = 0.017) and regaining normal size of inferior turbinate in 85,71% (6 of 7) subjects. While all of the PSG parameters did not had any significant changes with p > 0.05. PNN and mini FESS is effective to overcome nasal obstruction with SDB based on an improvement in the qualitative evaluations. Parasympathetic hyperreactivity resulting in inferior turbinate hypertrophy is a proven hypothesis; thus may enrich the theoretical framework on the pathophysiology of nasal obstruction in SDB."