A patient has persistent obstruction after septoplasty. Symptoms improve with a modified Cottle manoeuvre, and inspiration causes lateral-wall collapse. What is the best interpretation?
Septal correction alone cannot treat all obstruction. History, endoscopy and dynamic examination should identify valve narrowing or sidewall weakness; grafting or suture techniques are individualised.
A. The septum must always be re-resected: Further resection may worsen support and does not address the valve.
B. The response proves allergic rhinitis: Mechanical lateralisation improving airflow supports valve dysfunction.
C. Dynamic internal or external nasal-valve dysfunction requires targeted structural support: Septal correction alone cannot treat all obstruction. History, endoscopy and dynamic examination should identify valve narrowing or sidewall weakness; grafting or suture techniques are individualised.
D. Total turbinectomy is required: This risks functional harm and misses the site.
E. No objective examination is needed: Functional rhinoplasty requires documented anatomy and goals.
If obstruction fluctuated with allergen exposure and turbinates were oedematous without collapse, medical rhinitis treatment would be prioritised.
Independent Clinora educational preparation material; not official JCIE content, an accredited programme, clinical advice, or a substitute for current guidance, local policy and specialist judgement.
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