{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:28:59Z","timestamp":1790706539624,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,5,4]],"date-time":"2020-05-04T00:00:00Z","timestamp":1588550400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01 HL122154"],"award-info":[{"award-number":["R01 HL122154"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["NIHT32\u2010GM008719"],"award-info":[{"award-number":["NIHT32\u2010GM008719"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Internal nasal valve compromise is a major cause of nasal obstruction, with a growing number of ways to treat this condition. In this study, we compared the effects of butterfly graft, spreader graft, and the bioabsorbable nasal implant on nasal airflow resistance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Cadaver study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Computational fluid dynamics (CFD) simulations were completed from nine preoperative and postoperative cadaveric subjects. Each cadaveric head underwent placement of a bioabsorbable nasal implant (BNI) (Spirox Latera; Stryker ENT, Plymouth, MN), butterfly graft, or spreader graft. Pre\u2010 and postoperative computed tomography (CT) scans were used to generate three\u2010dimensional models of the nasal airway used in steady\u2010state CFD simulations of airflow and heat transfer during inspiration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Butterfly graft placement resulted in a mean improvement in nasal airway resistance of 24.9% (\u00b17.3), whereas BNI placement resulted in a 6.7% (\u00b11.2) improvement, and spreader graft placement also resulted in a consistent improvement of 2.6% (\u00b113.5). Pressure within the main nasal cavity was consistently lower following butterfly graft placement versus a spreader graft or BNI. Butterfly and spreader graft placement also resulted in modest improvements in airflow allocation, whereas BNI demonstrated more variation (\u22121% to 12%). Heat flux was not significantly different; however, a small improvement in total heat flux was seen with all three interventions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results of this study demonstrate reduction in nasal airway resistance in all three surgical interventions, with the butterfly graft demonstrating superiority to the other two techniques. However, these data only reflect a static environment and not dynamic changes in airflow seen during respiration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>NA <jats:italic>Laryngoscope<\/jats:italic>, 130:E817\u2013E823, 2020<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28691","type":"journal-article","created":{"date-parts":[[2020,5,4]],"date-time":"2020-05-04T13:34:03Z","timestamp":1588599243000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Nasal Airflow Changes With Bioabsorbable Implant, Butterfly, and Spreader Grafts"],"prefix":"10.1002","volume":"130","author":[{"given":"Bryan M.","family":"Brandon","sequence":"first","affiliation":[{"name":"Department of Otolaryngology University of North Carolina, School of Medicine  Chapel Hill North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2213-1872","authenticated-orcid":false,"given":"Wesley H.","family":"Stepp","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of North Carolina, School of Medicine  Chapel Hill North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1464-8425","authenticated-orcid":false,"given":"Saikat","family":"Basu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of North Carolina, School of Medicine  Chapel Hill North Carolina U.S.A."},{"name":"Department of Mechanical Engineering South Dakota State University  Brookings South Dakota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1969-6373","authenticated-orcid":false,"given":"Julia S.","family":"Kimbell","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of North Carolina, School of Medicine  Chapel Hill North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent A.","family":"Senior","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of North Carolina, School of Medicine  Chapel Hill North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William W.","family":"Shockley","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of North Carolina, School of Medicine  Chapel Hill North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Madison Clark","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of North Carolina, School of Medicine  Chapel Hill North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,4]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.02.007"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20495"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2010.04.019"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200211000-00002"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2017.1994"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2014.395"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2013.08.007"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2012.26.3766"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599813509776"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13344"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198402000-00013"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.130.11.1313"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20079"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e31818d45fb"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27776"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1672213"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1598655"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1089\/jamp.2014.1188"},{"key":"e_1_2_6_20_1","unstructured":"BasuS WittenN KimbellJ. 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