Impact of vertical dome division on nasal airflow

Objective: Vertical dome division is an effective maneuver in nasal tip sur gery. Its applications include reduction of the tip projection, increasing tip rotation, narrowing of the domal arch, and correction of lobule asymmet ry. Nevertheless, some surgeons avoid this technique, fearing tip deformity and possibly impaired nasal airflow. Results: In this study, nasal airflow measurements were made before and aft er septorhinoplasty with vertical dome division. There was no significant c hange in the airflow before and after septorhinoplasty with vertical dome d ivision. The airflow was negatively affected in 37.5% and improved postoper atively in 25% of patients. Conclusions: Despite objective findings of diminished nasal airflow in some patients following vertical dome division, no subjective correlation was i dentified. Furthermore, during the postoperative testing, alar retraction o n all of these patients failed to normalize airflow results, indicating tha t alar collapse was not contributing to the airflow impairment in those cas es. All of the patients were found clinically asymptomatic after surgery.