Abstract Objectives: Total laryngectomy (TL) patients are good models in which to evaluate the effects of nasal airflow cessation on the sinonasal tract. Here, we evaluated changes in sinonasal structures and association with chronic rhinosinusitis (CRS), in the computed tomography (CT) images three-year post-TL. Design: Retrospective medical chart review. Setting: Tertiary referral medical center, teaching hospital setting. Participants: Data from patients that underwent TL from 2005–2017 were reviewed retrospectively. Patients with a final follow-up CT taken less than 3 years after TL, tracheo-esophageal puncture, inadequate CT image, or history of sinonasal surgery were excluded. The control group included partial laryngectomy or hypopharyngectomy patients. Altogether, 45 TL patients and 38 controls were selected. Main outcome measurements: The volume of all four paranasal sinuses, inferior turbinate mucosal volume (ITMV), maxillary sinus natural ostium (MSNO) mucosal width, and Lund-Mackay scores (LMS) were measured on preoperative and postoperative CT scans. Results: The mean duration between surgery and the final CT scan was 6.3±2.4 and 5.5±2.3 years for the TL and control groups, respectively. Neither group showed significant changes in four paranasal sinuses volume or MSNO mucosa width. The ITMV decreased significantly, from 4.6±1.3ml to 2.8±1.1ml (p<0.001), in the TL group, whereas the control group showed no significant changes. Postoperative LMS changes in both groups were insignificant. The number of patients with LMS aggravation or alleviation was the same in both groups, regardless of preoperative CRS. Conclusions: Paranasal sinus structures and CRS are not affected significantly by nasal airflow cessation; however, the inferior turbinate mucosa is affected by long-term discontinuation of nasal airflow.

Objectives In clinical practice, lateral nasal wall collapse during forced inspiration is widely regarded as a sign of nasal obstruction or criterion indicating nasal valve surgery. This study aims to evaluate the relationship between the degree of lateral nasal wall collapse and subjective nasal obstruction. Design Case-Control study Setting Tertiary centre hospital Participants Case group consisted of 24 patients who had been diagnosed with a deviated nasal septum or nasal valve stenosis. Control group consisted of 27 volunteers with no nasal obstruction symptoms and no septal deviation on nasal endoscopy. Main outcome measures Lateral nasal wall collapse is determined by the degree of lateral nasal wall triangle (LNWT) area reduction on frontal view during forced inspiration compared to quiet inspiration. LNWT area ratio of the patient and control groups was compared. The relationship between the lateral nasal wall collapse and clinical factors including symptom scores, nasal valve angles, skin thickness were evaluated. Results The average LNWT area ratio of the patient (n=24) and control groups (n=27) was 0.96 and 0.83 respectively (p=0.001). Symptom score (NOSE and VAS) is not related to the degree of lateral nasal wall collapse. Moreover, nasal valve angle and skin thickness were also not related to the degree of lateral nasal wall collapse. In 14 of the 19 patients, the more obstructed side corresponded to the side of narrower nasal valve angle, and 5 were not. Conclusion Lateral nasal wall collapse is not related to a patients’ nasal obstruction.