Pyriform Aperture Enlargement Through a Rhinoplasty Approach.

[BACKGROUND] The pyriform aperture can limit airflow in some patients. In this study, the authors describe a new surgical technique to access and modify the pyriform aperture.

[OBJECTIVES] Describe the technique to measure the width of the pyriform aperture and surgically enlarge the pyriform aperture using ultrasonic instrumentation. Quantify improvement in nasal airway function with pyriform aperture size and Nasal Obstruction Symptom Evaluation (NOSE) scores.

[METHODS] The pyriform aperture was measured intraoperatively using calipers. Preoperative and postoperative NOSE scores were compared in a retrospective analysis to examine the effects of pyriform aperture enlargement on nasal breathing.

[RESULTS] On average, pyriform aperture width was enlarged by 2.9 mm ( < .0001) and NOSE scores decreased from 69.4 to 8.3 at 6 months ( < .0001).

[CONCLUSIONS] The pyriform aperture can be modified through an open rhinoplasty approach, and enlargement of the pyriform aperture can improve nasal obstruction symptoms.

[LEVEL OF EVIDENCE 5] (Therapeutic).