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

2006 ◽  
Vol 72 (6) ◽  
pp. 760-763 ◽  
Author(s):  
Pedro Wey Barbosa de Oliveira ◽  
Rogério Pezato ◽  
Luiz Carlos Gregório
2019 ◽  
Vol 6 (3) ◽  
pp. 3083-3087
Author(s):  
Seyed Mehdi Moosavizadeh ◽  
Hormoz Mahmoudvand ◽  
Sedigheh Nadri ◽  
Abdolreza Rouientan

Background: Correction of a crooked or deviated nose is a major challenge for rhinoplasty surgeons. In the present study we proposed to compare the aesthetic and functional results of unilateral grafting using spreader grafts on the convex side of the nasal deviation with those used on the concave side. Methods: In this study, the technique and aesthetic and functional outcomes of the correction of crooked noses with spreader graft placement at either convex or concave side of the nasal deviation are presented. Results: Unilateral spreader graft was used in 66 patients with C-type deviated nose. At the discretion of the rhinoplasty surgeon, the spreader graft was placed in the convex side of the nasal deviation in 33 patients (group A) and in the concave side of the nasal deviation in the remaining 33 patients (group B). During an average following-up period of 18 months (ranged from 8 to 36 months), there were no complications, infection, or graft extrusions. Functional evaluation was performed using a visual analog scale before and 4 months after surgery. Patients were asked to score their nasal breathing on a scale from 0 to 10. In group A (convex group), the mean preoperative score was 6.32+/-1.02 (ranging from 2 to 8), and the mean postoperative score was 2.03+/-1.01 (ranging from 0 to 4). In group B (concave group), the mean preoperative score was 6.76+/-1.10 (ranging from 2 to 8), and the mean postoperative score was 3.67+/-1.80 (ranging from 2 to 7). Patients with spreader graft at the convex side showed higher increase in angle measurements as compared to the patients with spreader graft in the concave side. Moreover, patients with spreader graft at the convex side were more likely to have excellent or good surgical outcomes (according to the degree of correction in the angle of deviation) as compared to patients with spreader graft in the concave side. Conclusion: The use of the spreader graft is a safe and effective method for correction of crooked noses. We showed that speeder graft at the convex side of C-type nose deformity provided better aesthetic and functional results as compared to the placement of the speeder graft in the concave side of the nasal deformity.    


2017 ◽  
Vol 33 (02) ◽  
pp. 157-161 ◽  
Author(s):  
Sami Moubayed ◽  
Sam Most

AbstractBy convention, a “deviated nose” is one in which the lower third is asymmetric with regard to the midline. The lower third of the nose is composed of the lower cartilages, as well as the dorsal and caudal nasal septum. Not only does the deviated nose cause a cosmetic deformity that is often disconcerting for patients, but it may also be associated with functional problems. Airway obstruction may result from a narrowed internal nasal valve in the middle third or from a deviated caudal septum in the lower third. The most common deviation involves both the middle and lower thirds and often requires addressing the underlying dorsal and caudal septum. The most effective technique to correct this type of deviation is the principle of extracorporeal septoplasty, either the traditional or modified, such as the anterior septal reconstruction (ASR) technique combined with the clocking suture. An isolated middle third deviation may be treated with a camouflage graft or a unilateral spreader graft. An isolated lower third deviation involving the septum should be treated with ASR. When an isolated lower third deviation only involves the lower cartilages, it may be corrected using suture techniques, cartilage division techniques, or grafting.


2012 ◽  
Vol 146 (5) ◽  
pp. 712-715 ◽  
Author(s):  
Mahmood Sadooghi ◽  
Matin Ghazizadeh
Keyword(s):  

2009 ◽  
Vol 62 (6) ◽  
pp. 604-608 ◽  
Author(s):  
Ahmet Seyhan ◽  
Sema Ozden ◽  
Melike Gungor ◽  
Diren Celik
Keyword(s):  

2021 ◽  
Vol 37 (01) ◽  
pp. 045-052
Author(s):  
Mario Bazanelli Junqueira Ferraz ◽  
Guilherme Constante Preis Sella

AbstractNasal dorsal preservation surgery was described more than 100 years ago, but recently has gained prominence. Our objective is to show the surgical technique, the main indications and counterindications, and the complications. It is a technique that does not cause the detachment of the upper lateral cartilage (ULC) from the nasal septum, and has the main following sequence: preparation of the septum and its resection can be at different levels (high or low, i.e., SPAR [septum pyramidal adjustment and repositioning] A or B); preparation of the pyramid; transversal osteotomy; lateral osteotomy(s); and septopyramidal adjustment. The result is a nose with a lower radix than the original, a deprojection of the nasal dorsum tending to maintain its original shape; an increase in the interalar distance (IAD) and enlargement of the nasal middle ⅓; and loss of projection of the nasal tip and roundness of the nostrils. Thus, the ideal candidate is the one who benefits from such side effects, that is: tension nose, that is, high radix with projected dorsum, projected anterior nasal septal angle (ANSA), narrow middle ⅓, narrow IAD, thin nostrils and straight perpendicular plate of the ethmoid (PPE), and, depending on the characteristics, the deviated nose. The counterindications are low radix, irregularities in the nasal dorsum, ANSA lower than rhinion, and a wide middle ⅓. And the main stigmas are: a nose with a very low radix, middle ⅓ enlarged, residual hump, and saddling of the supratip area. Other issues of this technique are: the shape of the radix; the need or not to remove PPE; wide dorsum; irregular dorsum; ANSA lower than rhinion; weak cartilages; long nasal bone; deviated PPE; and obsessive patient. We conclude that this is a great technique for noses with characteristics suitable to it; care must be taken with the stigmas it can cause.


1979 ◽  
Vol 72 (11) ◽  
pp. 848-851
Author(s):  
A G D Maran

The pathology of the deviated nose is discussed in relation to its bony and cartilaginous components. The importance of the interlocking stresses within the septal cartilage is pointed out especially with respect to continuing deformation after trauma. The methods of rhinometry are analysed and normal airflow through the nose is described. The effects on the nasal airway of a caudal dislocation of the septum, an angulation at the valve area, a high septal deflection and an excessively wide choana are discussed. In the treatment of a deviated bony segment the difficulties of medial and lateral osteotomies are described. The indications for a septoplasty are thought to be a dislocated caudal end, a tip deviation and an external lateral angulation. The submucous resection of the septum should be reserved for resolved haematoma and cartilage absorption. The importance of the patient's priorities in deciding what operation to do are pointed out. Finally the experimental work on the effect of cartilage and mucoperichondrium resection on nasal growth is reviewed. It is suggested that a child with a severe septal deflection and airway obstruction should be offered a septoplasty taking care not to damage the mucoperichondrium.


2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Maged Baher Naguib ◽  
Mohamed Rifaat Ahmed ◽  
Yasser Taha Madian ◽  
Tarek Mohamady Elnahriry ◽  
Wael Elshahat Eldeeb

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.


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