A Comparative Study of Isolated Osteotomies Versus Osteotomies with Spreader Graft Placement to Correct Primary Deviated Nose

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.

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Spreader graft placement: A simplified technique for young surgeons

International Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.ijom.2014.06.011 ◽

2014 ◽

Vol 43 (10) ◽

pp. 1216-1217 ◽

Cited By ~ 5

Author(s):

P. Varedi ◽

B. Bohluli ◽

M. Bayat ◽

F. Mohammadi

Keyword(s):

Spreader Graft ◽

Graft Placement

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Deviated nose correction by using the spreader graft in the convex side

Brazilian Journal of Otorhinolaryngology ◽

10.1016/s1808-8694(15)31042-9 ◽

2006 ◽

Vol 72 (6) ◽

pp. 760-763 ◽

Cited By ~ 2

Author(s):

Pedro Wey Barbosa de Oliveira ◽

Rogério Pezato ◽

Luiz Carlos Gregório

Keyword(s):

Convex Side ◽

Spreader Graft ◽

Deviated Nose

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Safety of 2-Octyl Cyanoacrylate in Spreader Grafting

Facial Plastic Surgery ◽

10.1055/s-0036-1597998 ◽

2017 ◽

Vol 33 (02) ◽

pp. 213-216 ◽

Cited By ~ 2

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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The Use of Spreader Grafts or Spreader Flaps—or Not—in Hump Reduction Rhinoplasty

Facial Plastic Surgery ◽

10.1055/s-0039-1695727 ◽

2019 ◽

Vol 35 (05) ◽

pp. 467-475

Author(s):

Deniz Gerecci ◽

Stephen W. Perkins

Keyword(s):

Surgical Techniques ◽

Spreader Graft ◽

Graft Placement ◽

Cosmetic Rhinoplasty ◽

Spreader Flap ◽

Hump Reduction

AbstractHump reduction is one of the most common reasons patients seek cosmetic rhinoplasty. Spreader grafts or spreader flaps have become a key maneuver in supporting and reconstructing the nasal midvault after reductive profileplasty to prevent long-term functional and cosmetic sequelae. This article reviews the pertinent anatomy, describes indications for spreader graft or spreader flap placement, discusses surgical techniques and approaches for spreader graft placement, and describes complications of spreader graft use after hump reduction.

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Evaluating the Effect of Spreader Grafting on Nasal Obstruction Using the NOSE Scale

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489416685320 ◽

2017 ◽

Vol 126 (3) ◽

pp. 219-223 ◽

Cited By ~ 6

Author(s):

Aurora G. Standlee ◽

Marc H. Hohman

Keyword(s):

Nasal Obstruction ◽

Surgical Techniques ◽

Spreader Graft ◽

Graft Placement ◽

Nose Scale ◽

Paired Samples ◽

Symptom Evaluation ◽

The Mean ◽

The Difference ◽

Mean Differences

Objective: The Nasal Obstruction Symptom Evaluation (NOSE) scale has been used to demonstrate that surgery improves nasal obstruction, but no study has directly compared surgical techniques. We performed a retrospective study comparing NOSE scores to quantify the effects of spreader grafting on postoperative nasal patency. Methods: We compared NOSE scores of patients who underwent septoturbinoplasty to open septorhinoplasty with spreader graft placement. We used a paired samples t test to evaluate the difference between pre- and postoperative NOSE scores and the improvement in NOSE score between patients who underwent septoturbinoplasty and those who underwent open septorhinoplasty with spreader graft placement. Results: Surgery reduced NOSE scores by an average of 46 points ( P < .001). The mean differences in NOSE score across all time points after septoturbinoplasty and septorhinoplasty with spreader graft placement was 40 and 49, respectively. The mean improvement in NOSE score at the second follow-up appointment was 27 for patients who had undergone septoturbinoplasty and 51 for patients who had undergone septorhinoplasty with spreader graft placement ( P = .04). Conclusion: This is the largest study quantifying the effect of spreader grafting. Greater improvement was observed from septorhinoplasty with spreader graft placement than septoturbinoplasty, and this improvement persisted over time.

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