Background: Nasal valve dysfunction (NVD) is a common yet underrecognized cause of nasal airway obstruction, with a significant impact on quality of life. Despite its clinical relevance, no universally accepted diagnostic standard exists, and optimal management remains debated. Multiple diagnostic tools and surgical or minimally invasive treatments have been proposed. This systematic review and meta-analysis aimed to evaluate current evidence regarding diagnostic approaches and treatment outcomes in NVD. Methods: A systematic search of PubMed/MEDLINE, Embase, and Cochrane Library was performed for studies published between January 1990 and January 2026, in accordance with PRISMA 2020 guidelines. Randomized controlled trials, non-randomized comparative studies, cohort studies, and case series (≥10 patients) assessing diagnostic methods or therapeutic interventions for NVD were included. Diagnostic data were synthesized narratively. The primary surgical outcome was change in the Nasal Obstruction Symptom Evaluation (NOSE) score. Risk of bias was assessed using RoB 2, ROBINS-I, and QUADAS-2 tools. Results: Seventy-two primary clinical studies were included (15 diagnostic, 57 treatment-focused). Objective airflow measurements, particularly rhinomanometry and peak nasal inspiratory flow, showed greater reliability than isolated clinical maneuvers. Imaging modalities provided anatomical detail but correlated inconsistently with symptoms. Meta-analysis of 12 studies (n = 1210 patients) suggests that both traditional surgical and minimally invasive interventions can substantially improve nasal breathing, with mean NOSE score reductions of 40–55 points, though heterogeneity precludes direct comparison of their relative effectiveness. Conclusions: Diagnosis of NVD requires a multimodal approach combining clinical assessment, validated symptom scores, and selective objective testing. Surgical and minimally invasive treatments provide substantial symptom improvement when appropriately indicated. Evidence is constrained by the predominance of observational data, emphasizing the need for standardized diagnostics and robust comparative trials.

Reproductive cells and tissue cryopreservation have revolutionized the provision of fertility services. The International Federation of Fertility Societies surveillance has collected global data on regulation and access to cryopreservation for many years. We used the triennial International Federation of Fertility Societies surveillance reports to assess trends, over the past 21 years, regarding the type of regulation implemented (none, statutes or guidelines), conditions for allowing use (medical/non-medical), tissue type and cryostorage duration permitted. We observed a 105.3% increase in the number of countries that regulate cryopreservation by statutes and 54.5% by guidelines. There has been a 103.6% increase in countries that allow cryopreservation for fertilized oocytes/preimplantation embryos, 205.3% for oocytes/ovarian tissue, and 134.6% for sperm/testicular tissue. More countries are allowing cryostorage surpassing 10 years, from 1% in 2001 to 25% in 2022. Since 2016, on average 15.6% of countries allow cryopreservation for medical reasons only, while allowance for non-medical reasons is growing. The number of countries reporting cryopreservation data has substantially increased, reflecting both customer demand and regulator awareness. Regulation by guidelines has decreased since 2010, while regulation by statutes has increased, indicating a shift towards more rigorous governing. To allow a better understanding of restrictions and facilitation of cryopreservation at a global level, an increase in the number of countries forwarding data on a regular basis is desirable, with clear benefits for regulators, practitioners, and patients.

Obesity [body mass index (BMI) ≥30 kg/m²] has been shown to be a risk factor in reducing the rate of successful in vitro fertilization (IVF) outcomes. In this systematized literature review, we investigate whether embryo quality specifically is affected by single-parent obesity (maternal or paternal) and obesity in both parents at the time of conception. We systematically searched for studies published over the last 10 years that graded embryo quality in conventional IVF and intracytoplasmic sperm injection procedures. Studies that did not use measured weight and height for BMI calculation were excluded. Ten eligible articles were found across 13 public databases. Comparing the results of 1845 couples, both female and male obesity independently caused faster preimplantation embryo development (P 0.05). Day 3 embryo quality does not seem to be affected by either female or male obesity alone. The 2 studies that investigated the effect of combined parental obesity on embryo quality reached contradictory findings. Male, but not female, >7% BMI reduction following bariatric surgery significantly increased the number of top-quality embryos compared with their results before surgery (P<0.05). We conclude that embryos of couples with single-parent obesity are not of lower quality compared with those of normal-weight parents. Combined parental obesity may affect embryo quality. BMI reduction could lead toward a successful outcome in obese infertile couples, regardless of whether they are undergoing IVF or not.

The resting angle forms between the lateral crus of the lower lateral cartilage (LLC) and the upper lateral cartilage. While conventional nasal valve repair relies on cartilage grafting for reinforcement of these structures, the functional significance of resting angle adjustment remains underexplored. We describe a technique to reposition the LLC, adjusting the resting angle to support the lateral nasal wall and restore external nasal valve (ENV) function without grafts, with the hypothesis that this approach improves functional and aesthetic outcomes. Retrospective cohort study. We retrospectively identified patients with ENV collapse-related nasal obstruction who underwent the described surgery. Pre- and postoperative peak nasal inspiratory flow (PNIF) measurements and FACE-Q scores were compared to evaluate functional and aesthetic improvement, respectively. Thirty patients (22 female, 8 male) were included. Postoperatively, median PNIF increased from 74.0 L/minute (interquartile range [IQR]: 73.0–76.0; 95% confidence interval [CI]: 72.5–75.5) to 96.0 L/minute (IQR: 93.0–97.0; 95% CI: 94.0–97.5), and median FACE-Q Satisfaction with nose scores from 17 (IQR: 16.0–18.0; 95% CI: 16.0–17.5) to 37 (IQR: 35.0–38.0; 95% CI: 36.5–37.5); both improvements were statistically significant (p < 0.001). Resting angle correction may not only improve aesthetics, but also stabilize the lateral nasal wall to prevent or repair ENV collapse.

The internal nasal valve (INV) is a key determinant of nasal airflow and is dependent on middle vault integrity. While spreader grafts remain the gold standard for reconstruction, the spreader flap offers a tissue-preserving alternative. This study evaluates outcomes of a modified spreader flap tension suture technique with composite flap elevation in 580 patients, with the hypothesis that this approach yields favorable functional improvements. Retrospective cohort study. Patients who underwent the described procedure were retrospectively identified. Inclusion required a dorsal hump reduction of >3 mm in all cases. Patients were stratified into three groups according to clinical presentation: those undergoing dorsal refinement alone, those with concurrent septal deviation or turbinate hypertrophy, and those with primary INV insufficiency. Prior dorsal rhinoplasty or significant septal deviation were exclusion criteria. Pre- and postoperative (6 months) peak nasal inspiratory flow (PNIF) measurements and visual analog scale (VAS) scores were compared to evaluate objective and subjective functional improvement, respectively. The dorsal refinement group (n = 362) demonstrated stable functional outcomes, with a mean VAS improvement of 2 points. The septal deviation/turbinate hypertrophy group (n = 158) had a mean PNIF increase of 27 L/minute and a 3.5-point VAS improvement, while the INV insufficiency group (n = 60) showed greater gains (PNIF +35 L/minute; VAS +5 points). The modified spreader flap is an effective, cartilage-preserving technique for INV reconstruction, yielding consistent functional and aesthetic outcomes. Further controlled studies are required to assess long-term results.

Isolated congenital lower lateral cartilage (LLC) anomalies are incidental intraoperative findings that challenge surgical planning. Despite their role in external nasal valve (ENV) support, variable clinical presentation suggests the existence of compensatory mechanisms that warrant further investigation. We evaluate the available evidence on isolated congenital LLC deficiency to explore reported preoperative nasal valve dysfunction and surgical outcomes, with the hypothesis that the available evidence demonstrates an association between isolated congenital LLC deficiency and nasal valve dysfunction. Preferred Reporting Items for Systematic Reviews and Meta-Analyses-compliant systematic review and case series. A systematic search of three databases was undertaken to identify reports of isolated congenital LLC deficiency. Studies without intraoperative confirmation and those involving pediatric populations were excluded. The validated Joanna Briggs Institute (JBI) Critical Appraisal Tools and Case Report Guidelines were used to assess evidence quality. Fifteen studies (n = 18) were eligible, comprising 14 case reports and one case series. Unilateral involvement was most common (n = 16), with the middle crus most frequently affected. Eight patients were asymptomatic. Only three studies were rated as high quality (JBI: 6–7/8). In our case series, the incidence of isolated congenital LLC absence was 0.002, and lateral crus absence was asymptomatic, whereas absence of the medial and middle crura was associated with dynamic ENV collapse. These observations are hypothesis-generating, suggesting a greater functional role for medial crus integrity in nasal valve competence, with lateral crus absence appearing more consistently asymptomatic across the literature. Potential compensatory mechanisms may help preserve nasal valve function despite isolated LLC deficiency, a rare anomaly that underscores the need for intraoperative preparedness and tailored reconstruction when encountered incidentally.