Open AccessClinical consensus statement: Diagnosis and management of nasal valve compromise
Author(s) -
Rhee John S.,
Weaver Edward M.,
Park Stephen S.,
Baker Shan R.,
Hilger Peter A.,
Kriet J. David,
Murakami Craig,
Senior Brent A.,
Rosenfeld Richard M.,
DiVittorio Danielle
Publication year - 2010
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1016/j.otohns.2010.04.019
Subject(s) - compromise , medicine , delphi method , physical examination , statement (logic) , medical physics , surgery , computer science , political science , artificial intelligence , law
Objective To create a clinical consensus statement to address ambiguities and disparities in the diagnosis and management of nasal valve compromise (NVC). Subjects and Methods An updated systematic review of the literature was conducted. In addition, a Modified Delphi Method was used to refine expert opinion and facilitate a consensus position. Results After two rounds of surveys and conference calls, 36 items reached consensus, six items reached near consensus, and 10 items reached no consensus. The categories that had the greatest percentage of consensus or near consensus items were as follows: definition, history and physical examination, outcome measures, and management. Conversely, the categories with greater percentage of no consensus items were adjunctive tests and coding. Conclusion The consensus panel agreed that NVC is a distinct clinical entity that is best evaluated with history and physical examination findings. Endoscopy and photography are useful but not routinely indicated, whereas radiographic studies are not useful in evaluating NVC. Other objective nasal outcome measures may not be useful or accepted for NVC. Nasal steroid medication is not useful for treatment of NVC in the absence of rhinitis, and mechanical treatments may be useful in selected patients. Surgical treatment is the primary mode of treatment of NVC, but bill coding remains ambiguous and confusing.