Endonasal Spreader Graft Placement as Treatment for Internal Nasal Valve Insufficiency

2004 ◽  
Vol 6 (1) ◽  
pp. 36-40 ◽  
Author(s):  
Robert F. André ◽  
Santdeep H. Paun ◽  
Hadé D. Vuyk
Keyword(s):  
Nasal Valve ◽  
Spreader Graft ◽  
Graft Placement ◽  
Valve Insufficiency

A novel technique for spreader graft placement without dorsum resection during septoplasty

2015 ◽  
Vol 129 (10) ◽  
pp. 1025-1027 ◽  
Author(s):  
E Kaya ◽  
T Catli ◽  
H Soken ◽  
C Cingi
Keyword(s):  
Operation Time ◽  
Graft Material ◽  
Open Approach ◽  
Nasal Valve ◽  
Surgical Team ◽  
Spreader Graft ◽  
Graft Placement ◽  
Novel Technique ◽  
Novel Method ◽  
Valve Angle

AbstractObjective:This paper presents a novel method for spreader graft placement without dorsum resection in patients who have a deviated septum with a narrow internal nasal valve angle.Methods:A Killian incision was used for the endonasal septoplasty, and all spreader grafts were harvested from excised deviated septal cartilages. Procedures were conducted under general anaesthesia at the same centre by the same surgical team that performed the endonasal procedure. Successful placement of spreader grafts was achieved endonasally.Conclusion:Although the endonasal placement of spreader grafts seems to be more difficult than placement conducted by an open approach technique, an endonasal procedure has many advantages. Our technique provides surgeons with the opportunity to shorten operation time, obtain autologous septal graft material and secure the columellar architecture. Surgeons familiar with the classical (endonasal) septoplasty procedure can easily apply this technique to widen a narrow internal nasal valve angle, without corrupting nasal integrity.

scholarly journals Functional and aesthetic outcomes of spreader graft and auto-spreader flap after nasal hump removal

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Maged Baher Naguib ◽  
Mohamed Rifaat Ahmed ◽  
Yasser Taha Madian ◽  
Tarek Mohamady Elnahriry ◽  
Wael Elshahat Eldeeb
Keyword(s):  
Nasal Obstruction ◽  
Operative Time ◽  
Nasal Valve ◽  
Spreader Graft ◽  
Spreader Flap ◽  
The Mean ◽  
The Difference ◽  
A New Technique ◽  
Nasal Valve Collapse ◽  
Duration Of Operation

Abstract Background Following the reduction of the nasal hump to a desired level, spreader grafts are usually positioned to prevent the complication of nasal valve collapse. Auto-spreader flap is a new technique that gained more popularity recently and can be used as an alternative to spreader graft. This RCCT compared between both techniques aesthetically and functionally as well as the operative time. Results Forty patients, 17 males (42.5%) and 23 females (57.5%), were included. The mean duration of operation in auto-spreader flap was 11.8 ± 3.4 min, while it was 19.2 ± 3.2 min in spreader graft. The difference between the two procedures was statistically significant (P < 0.05). Functional assessment of nasal obstruction was done for all patients in both groups preoperative that was (75.6 ± 19.9) which showed marked improvement when re-evaluated 3 moths postoperatively (18.9 ± 14.7), and after 6 months NOSE scale was (29.1 ± 20.2). The overall aesthetic satisfaction was 62.5% (25 of 40) irrespective of the surgery done. Sixteen out of 20 patients in spreader group and 9 out of 20 in auto-spreader flap group. Conclusion Auto-spreader flap and spreader graft are very effective surgical procedure for treatment of nasal obstruction due to internal nasal valve dysfunction, but the auto-spreader flap had shorter operative time. However, spreader graft has a superior aesthetic outcome.

Significance of Inner Nasal Valve In Septoplasty

2021 ◽  
Vol 8 (1) ◽  
pp. 3-8
Author(s):  
Dr. Shraddha Subhash Bhoyar ◽  
Dr. Gajanan Mohniraj Kashid ◽  
Dr. Ashok Gaikwad ◽  
Dr. Siddharth Ashok Purohit ◽  
Dr. Amit Shekhar Gupta ◽  
...  
Keyword(s):  
Retrospective Review ◽  
Symptomatic Improvement ◽  
Functional Improvement ◽  
Nasal Valve ◽  
Nasal Surgery ◽  
Spreader Graft ◽  
Persistent Symptoms ◽  
Septal Surgery ◽  
Valve Angle ◽  
Valve Area

Background: Nasal obstruction due to deviated septum is commonly treated with conventional septoplasty. This surgery however is inadequate in cases of compromised nasal valves and leads to persistent symptoms. Hence, we stressed the evaluation of nasal valves before septal surgery & studied the outcome of  the patients with valve area correction. Aim: To prove the significance of inner nasal valve in nasal surgery. Objective : To analyse the outcome of  Open septoplasty. Methodology:A  retrospective review of  our patients undergoing Open septoplasty was analysed from April 2016 to January 2021. The preoperative and post operative evaluations were calculated & statistically analysed. Results : A total of 400 patients underwent Open septoplasty. Out of which 392(98%) showed symptomatic improvement in breathing difficulty &   380(95%) were happy with the asthetic improvement.  Conclusion: Open septoplasty and Spreader grafts is best solution to improve Internal Nasal valve angle. Rim graft to improve external valve collapse. Spreader graft also gives asthetic & functional improvement

Comparative Outcomes in Functional Rhinoplasty With Open vs Endonasal Spreader Graft Placement

2018 ◽  
Vol 80 (5) ◽  
pp. 468-471
Author(s):  
Jason Talmadge ◽  
Robin High ◽  
William Wesley Heckman
Keyword(s):  
Spreader Graft ◽  
Graft Placement

Spreader graft placement: A simplified technique for young surgeons

2014 ◽  
Vol 43 (10) ◽  
pp. 1216-1217 ◽  
Author(s):  
P. Varedi ◽  
B. Bohluli ◽  
M. Bayat ◽  
F. Mohammadi
Keyword(s):  
Spreader Graft ◽  
Graft Placement

scholarly journals The Use of Bony Septum as an Extended Spreader Graft in Primary and Secondary Rhinoplasty

2019 ◽  
Vol 34 (1) ◽  
pp. 20-25
Author(s):  
Candice Que - Ansorge ◽  
Eduardo C. Yap
Keyword(s):  
Surgical Technique ◽  
Effective Means ◽  
Case Series ◽  
Septal Cartilage ◽  
Direct Vision ◽  
Nasal Valve ◽  
Spreader Graft ◽  
Secondary Rhinoplasty ◽  
Aesthetic Rhinoplasty ◽  
Nasal Length

Objective:  To describe a surgical technique using bony septum, specifically vomer or perpendicular plate of the ethmoid (PPE), as an extended spreader graft (ESG) for securing septal extension graft (SEG) and for correcting internal nasal valve dysfunction. Methods:             Design: Descriptive Case Series             Setting:           Tertiary Private Hospital             Participants: Thirty-two (32) patients who underwent aesthetic rhinoplasty from May 2016 to October 2017 were evaluated, and ten (10) patients presenting with symptomatic obstruction were considered for inclusion. The surgical technique was applied in patients with weak SEG for control of nasal length and tip projection who had inadequate septal cartilage for SEG and ESG intraoperatively. Results were evaluated grossly under direct vision intra-operatively and post-operatively to check the patency of the internal valve. Results:  Bony septum was used as an ESG in five (5) patients (1 male, 4 females, ages 35 to 50-years-old) with inadequate septal cartilage. Intraoperative evaluation under direct vision showed anterior caudal septal deviation in all 5 patients in whom correction was confirmed after placement of SEG and ESG. Immediate post-operative evaluation confirmed bilaterally patent nasal valve in all 5, who reported subjectively improved breathing at 2 and 4 weeks post-operatively.  Post-operative photographs showed improvement of nasal length and tip. Conclusion: The use of the bony septum (vomer and PPE) as an ESG for primary or secondary rhinoplasty is a potentially effective means of supporting and securing the SEG for control of nasal length, preventing tip deviation or rotation and for improving internal valve function. Further trials are needed to establish its reliability and long-term effectivity. Keywords: rhinoplasty; vomer; perpendicular plate of the ethmoid (PPE)

Safety of 2-Octyl Cyanoacrylate in Spreader Grafting

2017 ◽  
Vol 33 (02) ◽  
pp. 213-216 ◽  
Author(s):  
Aurora Standlee ◽  
Marc Hohman
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Final Analysis ◽  
Spreader Graft ◽  
Chi Square ◽  
Inflammatory Reactions ◽  
Graft Placement ◽  
Postoperative Inflammation ◽  
Academic Medical

AbstractCyanoacrylate adhesives can make the placement of spreader grafts in open septorhinoplasty technically easier, but its use is off-label beneath the skin. There is a theoretical risk of toxicity from cyanoacrylate breakdown products, but this risk has not been thoroughly studied in rhinoplasty. The objective was to evaluate the effects of subcutaneous cyanoacrylate use during spreader graft placement in rhinoplasty in a retrospective review of open septorhinoplasties in which 2-octyl cyanoacrylate was used to aid placement of spreader grafts. The review was carried out in a tertiary care military academic medical center. A total of 140 adults underwent open septorhinoplasty between September 2013 and May 2016 with spreader graft placement. The authors excluded patients in whom 2-octyl cyanoacrylate was not used to aid graft placement and those who did not follow up postoperatively in our clinic. 108 (85 males and 23 females) patients were included in the final analysis. Nine (8.3%) patients had inflammatory reactions possibly attributable to 2-octyl cyanoacrylate toxicity. The overall rate of postoperative inflammation possibly attributable to 2-octyl cyanoacrylate was 17% among females and 5.9% among males, and this difference was not statistically significant (p = 0.07). However, the rate of postoperative inflammation attributable to 2-octyl cyanoacrylate that required an intervention (incision and drainage or antibiotics) was 2.7% overall, 13% among women and 0% among men, and this difference was significant based on chi-square testing (p < 0.001). Further, revision cases were significantly more likely to develop abnormal postoperative inflammation than initial cases (p = 0.02). Herein, the authors present the largest series of patients in whom 2-octyl cyanoacrylate was used to assist placement of cartilage spreader grafts during open septorhinoplasty. While 2-octyl cyanoacrylate is an effective adjunct to facilitate graft placement, they recommend against its use, as the risk of postoperative inflammation is significant.

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