{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T21:02:16Z","timestamp":1789938136772,"version":"4.0.1"},"reference-count":20,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2018,11,1]],"date-time":"2018-11-01T00:00:00Z","timestamp":1541030400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["JAMA Facial Plast Surg"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Understanding the skin biomechanics, specifically pliability and elasticity, in patients with nasal valve collapse may allow for new methods to assess which patients require more advanced nasal valve surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To test the hypothesis that in patients with unilateral nasal valve collapse, the side of the nose with the collapse will have lower elasticity and increased pliability compared with the normal side, as assessed by a blinded observer using the Cutometer MPA 580.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>Prospective, investigator-blinded, case-control cohort study of patients with unilateral nasal valve collapse and subjective nasal obstruction conducted in an academic otolaryngology\u2013head and neck surgery clinic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Patients were assessed using the Cutometer MPA 580 by a blinded assessor. Three measurements were performed bilaterally on the exterior skin of the nose corresponding to the level of the inferior edge of the upper lateral cartilage. Measurements taken at the skin inferior to the zygoma were used as a control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>\n                      Primary outcome measures of the nasal skin were pliability (\n                      <jats:italic toggle=\"yes\">Uf<\/jats:italic>\n                      , defined as the lengthening of the skin after 3 seconds of constant load) and elasticity (\n                      <jats:italic toggle=\"yes\">Ua\/Uf<\/jats:italic>\n                      , defined as the percentage of the skin that returned to its normal position 3 seconds after the release from the 3-second constant load).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 27 patients included in the study, 15 (56%) were male, and 12 (44%) were female; mean (SD) age, 44 (21) years (range, 16-90 years). There was no difference between the measurements of the skin overlying the area of nasal valve collapse in elasticity: side without collapse (0.960% [0.031%]) vs side with collapse (0.967% [0.036%]) (mean difference, 0.007%; 95% CI, \u22120.018% to 0.021%) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.90). However, there was a significant difference in pliability: side of the nose without collapse (0.520 [0.139] mm) vs side with collapse (0.610 [0.200]) (mean difference, 0.090 mm; 95% CI, 0.014-0.156 mm) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>Although the skin in patients with nasal valve collapse appears to maintain its elasticity, it demonstrates an increased ability to stretch and lengthen compared with nasal skin of those without valve collapse. Future studies are required to determine whether the biomechanical changes are related to the length and severity of nasal obstruction, or whether these changes in the skin may help predict who will benefit from nasal valve surgery and whether these patients are at an increased risk of surgical failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/jamanetwork.com\/journals\/jamafacialplasticsurgery\/pages\/instructions-for-authors\/#SecLevelofEvidence\/Ethnicity\">2<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamafacial.2018.0861","type":"journal-article","created":{"date-parts":[[2018,8,9]],"date-time":"2018-08-09T13:58:28Z","timestamp":1533823108000},"page":"475-479","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Assessment of Pliability and Elasticity of the External Nasal Skin in Patients With Unilateral Nasal Valve Collapse"],"prefix":"10.1177","volume":"20","author":[{"given":"James P.","family":"Bonaparte","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,11,15]]},"reference":[{"issue":"1","key":"e_1_3_1_2_2","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.2500\/ar.2012.3.0020","article-title":"Quality of life comparison in common rhinologic surgeries","volume":"3","author":"Naraghi M","year":"2012","unstructured":"Naraghi M, , Amirzargar B, , Meysamie A. Quality of life comparison in common rhinologic surgeries. Allergy Rhinol (Providence). 2012; 3(1):e1-e7. doi:10.2500\/ar.2012.3.0020, 22852123","journal-title":"Allergy Rhinol (Providence)"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/000348947007900308"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oooo.2013.01.007"},{"key":"e_1_3_1_5_2","first-page":"S20","article-title":"Healing time of radial forearm free flap donor sites after preoperative tissue expansion: randomized controlled trial","volume":"40","author":"Bonaparte JP","year":"2011","unstructured":"Bonaparte JP, , Corsten MJ, , Allen M. Healing time of radial forearm free flap donor sites after preoperative tissue expansion: randomized controlled trial. J Otolaryngol Head Neck Surg. 2011; 40(suppl 1):S20-S27. 21453657","journal-title":"J Otolaryngol Head Neck Surg"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2015.0978"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2010.04.019"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2015.0376"},{"issue":"5","key":"e_1_3_1_9_2","first-page":"427","article-title":"Cosmetic and functional outcomes after preoperative tissue expansion of radial forearm free flap donor sites: a cohort study","volume":"40","author":"Bonaparte JP","year":"2011","unstructured":"Bonaparte JP, , Corsten MJ, , Allen M. Cosmetic and functional outcomes after preoperative tissue expansion of radial forearm free flap donor sites: a cohort study. J Otolaryngol Head Neck Surg. 2011; 40(5):427-435. 22420399","journal-title":"J Otolaryngol Head Neck Surg"},{"key":"e_1_3_1_10_2","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/1916-0216-43-8","article-title":"The effect of topically applied tissue expanders on radial forearm skin pliability: a prospective self-controlled study","volume":"43","author":"Chung J","year":"2014","unstructured":"Chung J, , Bonaparte JP, , Odell M, , Corsten M. The effect of topically applied tissue expanders on radial forearm skin pliability: a prospective self-controlled study. J Otolaryngol Head Neck Surg. 2014; 43:8. doi:10.1186\/1916-0216-43-8, 24739510","journal-title":"J Otolaryngol Head Neck Surg"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-199808000-00019"},{"issue":"2","key":"e_1_3_1_12_2","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1111\/j.1600-0846.2004.00057.x","article-title":"Model of the viscoelastic behaviour of skin in vivo and study of anisotropy","volume":"10","author":"Khatyr F","year":"2004","unstructured":"Khatyr F, , Imberdis C, , Vescovo P, , Varchon D, , Lagarde JM. Model of the viscoelastic behaviour of skin in vivo and study of anisotropy. Skin Res Technol. 2004; 10(2):96-103. doi:10.1111\/j.1600-0846.2004.00057.x, 15059176","journal-title":"Skin Res Technol"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198301000-00009"},{"key":"e_1_3_1_14_2","first-page":"618313","article-title":"The effectiveness of modified Cottle maneuver in predicting outcomes in functional rhinoplasty","volume":"2014","author":"Fung E","year":"2014","unstructured":"Fung E, , Hong P, , Moore C, , Taylor SM. The effectiveness of modified Cottle maneuver in predicting outcomes in functional rhinoplasty. Plast Surg Int. 2014; 2014:618313. 25243085","journal-title":"Plast Surg Int"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2003.12.004"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2003.09.016"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.3109\/03091902.2013.876111"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0846.2011.00515.x"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.3109\/03091902.2013.779325"},{"issue":"6","key":"e_1_3_1_20_2","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1177\/0194599814526558","article-title":"Skin biomechanical changes after injection of onabotulinum toxin A: prospective assessment of elasticity and pliability","volume":"150","author":"Bonaparte JP","year":"2014","unstructured":"Bonaparte JP, , Ellis D. Skin biomechanical changes after injection of onabotulinum toxin A: prospective assessment of elasticity and pliability. Otolaryngol Head Neck Surg. 2014; 150(6):949-955. doi:10.1177\/0194599814526558, 24664544","journal-title":"Otolaryngol Head Neck Surg"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2011.08.006"}],"updated-by":[{"DOI":"10.1001\/jamafacial.2017.1549","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2018,11,15]],"date-time":"2018-11-15T00:00:00Z","timestamp":1542240000000}}],"container-title":["JAMA Facial Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1001\/jamafacial.2018.0861","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1001\/jamafacial.2018.0861","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1001\/jamafacial.2018.0861","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:25:56Z","timestamp":1777443956000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1001\/jamafacial.2018.0861"}},"subtitle":["A Static Biomechanical Evaluation"],"short-title":[],"issued":{"date-parts":[[2018,11]]},"references-count":20,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1001\/jamafacial.2018.0861"],"URL":"https:\/\/doi.org\/10.1001\/jamafacial.2018.0861","relation":{},"ISSN":["2168-6076","2168-6092"],"issn-type":[{"value":"2168-6076","type":"print"},{"value":"2168-6092","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11]]}}}