Table of Contents
Plastic Surgery International
Volume 2014, Article ID 618313, 6 pages
Research Article

The Effectiveness of Modified Cottle Maneuver in Predicting Outcomes in Functional Rhinoplasty

1Department of Surgery, Dalhousie University, 5850 University Avenue, Halifax, NS, Canada B3H 2Y9
2Department of Surgery, IWK Health Centre, 5850/5920 University Avenue, P.O. Box 9700, Halifax, NS, Canada B3K 6R8
3Department of Otolaryngology-Head and Neck Surgery, University of Western Ontario, London, ON, Canada N6B 2P2

Received 5 June 2014; Accepted 9 August 2014; Published 25 August 2014

Academic Editor: Selahattin Özmen

Copyright © 2014 Elaine Fung et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To assess the outcomes of functional rhinoplasty for nasal valve incompetence and to evaluate an in-office test used to select appropriate surgical techniques. Methods. Patients with nasal obstruction due to nasal valve incompetence were enrolled. The modified Cottle maneuver was used to assess the internal and external nasal valves to help select the appropriate surgical method. The rhinoplasty outcomes evaluation (ROE) form and a 10-point visual analog scale (VAS) of nasal breathing were used to compare preoperative and postoperative symptoms. Results. Forty-nine patients underwent functional rhinoplasty evaluation. Of those, 35 isolated batten or spreader grafts were inserted without additional procedures. Overall mean ROE score increased significantly () from 41.9 ± 2.4 to 81.7 ± 2.5 after surgery. Subjective improvement in nasal breathing was also observed with the VAS (mean improvement of 4.5 (95% CI 3.8–5.2) from baseline ()). Spearman rank correlation between predicted outcomes using the modified Cottle maneuver and postoperative outcomes was strong for the internal nasal valve (Rho = 0.80; ) and moderate for the external nasal valve (Rho = 0.50; ). Conclusion. Functional rhinoplasty improved subjective nasal airflow in our population. The modified Cottle maneuver was effective in predicting positive surgical outcomes.