The Transoral Alar Batten Graft: A Functional Rhinoplasty Technique for the Orthognathic Jaw Surgery Patient

Overview

Many patients having orthognathic jaw surgery also have a blocked nose. Existing techniques let the surgeon straighten the septum and reduce the turbinates through the mouth once the upper jaw is down fractured, but those do not address dynamic collapse of the nasal sidewall on breathing in. This article describes a transoral alar batten graft to fill that gap.

Sections of note

• Article type: technique description. No patient series, numbers or outcomes appear in the abstract.
• Existing transoral options named: septoplasty and inferior turbinate reduction, after maxillary down fracture.
• Stated gap: neither of those treats dynamic nasal sidewall collapse.
• Technique: septal cartilage is harvested through the maxillary vestibular approach, then passed through a small tunnel into the junction of the nostril rim and sidewall.
• Claims: simple, versatile, minimal morbidity, improving nasal function. No measurements support these claims.

What it means for a patient

• If you are already having upper jaw surgery, this puts a sidewall support graft in without adding a separate nasal operation or an external scar.
• Dynamic collapse means the sidewall caves in when you breathe in hard. It is a distinct cause of blockage from a crooked septum and needs structural support to fix.
• The abstract reports no outcomes: no breathing scores, no patient count, no follow up, no complication data.

Why this paper matters

Jaw surgery changes the shape and support of the nose, and nasal blockage in these patients is often left untreated because it would mean a second operation. Extending what can be done through the existing mouth incision is a practical answer. A patient series with breathing scores would be needed to know whether it works.

Terms

• Alar batten graft: a cartilage strip placed under the nasal sidewall to keep it from collapsing.
• Orthognathic surgery: surgery to reposition the jaws.
• Transoral: performed through the mouth.
• Maxillary vestibular approach: an incision inside the upper lip giving access to the upper jaw.
• Dynamic nasal sidewall collapse: inward caving of the side of the nose during inhalation.