الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Internal nasal valve (INV) is the narrowest area, of the nose where turbulence of the inspiratory and expiratory current takes place.The airflow resistance provided by the airways during breathing is essential for good pulmonary function. The nose is responsible for almost two thirds of this resistance. Most of this resistance occurs in the anterior part of the nose. This region is called the nasal valve, and it acts as a flow-limiter.The study included 50 patients with internal nasal valve collapse. The patients were randomly divided into two groups: open approach, and closed approach. Randomizaton was performed based on a computer-generated list of random numbers.•group A, 25 patients.•group B, 25 patients.•Randomly chosen. Patients with internal nasal valve stenosis have several surgical options for repair, but the spreader graft remains one of the most familiar and common techniques. Spreader grafts can be placed via an open or an endonasal approach with no statistically significant difference in outcomes.In our study we use spreader graft in open and closed approach to correct INV angle.In our study we have used the computed topography (CT) in the cronal reformatted view (NBV) to measure the INV angle preoperatively and postoperatively as an objective method to evaluate the improvement in the patient internal nasal valve angle after performing spreader graft also we used cottle test, questionnaire, video endoscopy with digital imaging to document the results.Closed approach provide a simplification procedure to treat nasal obstruction caused by an incompetent internal nasal valve. The most widely recommended solution for this problem is widening the nasal valve angle by placing spreader grafts between the upper lateral cartilages and the septum.