A 40-year-old man complains of bilateral nasal blockage maximal during forced inspiration, present since a nasal trauma one year ago. Pulling his cheek laterally away from the midline relieves the obstruction. Which procedure directly addresses the cause of his symptoms?
- A Septoplasty alone
- B Inferior turbinate reduction
- C Placement of spreader grafts ✓
- D Alar base reduction
Correct answer: C. Placement of spreader grafts
Explanation
Lateral distraction relieving obstruction is a positive Cottle test, indicating internal nasal valve collapse from post-traumatic narrowing of the septo-upper lateral cartilage angle. Spreader grafts are longitudinal cartilage strips placed between the septum and upper lateral cartilage to widen this angle. Septoplasty corrects a deviated septum, turbinate surgery addresses hypertrophy, and alar base reduction narrows the nostrils, none of which restores valve angle patency.
Reference: Scott-Brown's Otorhinolaryngology and Head and Neck Surgery, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.