Spreader Graft Versus Spreader Flap in Rhinoplasty: A Systematic Review and Meta-Analysis of Aesthetic and Functional Outcomes

Background Insufficient support of the nasal mid-vault during rhinoplasty can cause significant complications. Accordingly, surgeons recently pay much more attention to the preservation of nasal patency. The spreader graft is the gold standard technique for the reconstruction of nasal mid-vault. Objectives The objective of this study was to compare the spreader graft and spreader flap in terms of aesthetic and functional outcomes. Methods An inclusive search was performed using PubMed/Medline, Google Scholar, Cochrane Library databases up to April 2021. Multiple aesthetic and functional factors including dorsal aesthetic lines restoration, satisfaction rate, internal nasal valve angle improvement, nasal obstruction symptom evaluation (NOSE) scale, and active anterior rhinomanometry (AAR) were evaluated. Also, a meta-analysis was performed on included articles that provided adequate data for mentioned factors. Results After excluding papers that did not conform with the selection criteria, 10 articles with a total sample size of 567 cases with a mean age of 27.7 (range: 18- 65) were finally included. Analysis of the data revealed no statistically significant difference between the spreader graft and spreader flap techniques in terms of dorsal aesthetic lines restoration, internal nasal valve angle improvement, NOSE scale, and AAR. Conclusions However, in terms of satisfaction rate, the analyzes indicated that spreader graft has significantly superior aesthetic outcomes. Generally, in case of appropriately selected patients, there is no statistically significant difference between spreader graft and spreader flap techniques in terms of aesthetic and functional outcomes.

Significance of Inner Nasal Valve In Septoplasty

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