The Role of a Diced Inverted Y Shaped Spreader Graft to Enhance Function in Open Rhinoplasty. A Novel Technique

El Sherif, Ahmed F; Kamel, Ibrahim H

doi:10.21608/ejprs.2019.65109

The Role of a Diced Inverted Y Shaped Spreader Graft to Enhance Function in Open Rhinoplasty. A Novel Technique

Document Type : Original Article

Authors

The Department of Plastic & Reconstructive Surgery, Faculty of Medicine, Ain Shams University

10.21608/ejprs.2019.65109

Abstract

The role of spreader grafts in open rhinoplasty
is at times mandatory. Various studies have shown that spreader
grafts mot only support nasal function by maintaining the
nasal valve support, but also restore nasal dorsum aesthetics
and camouflage minor dorsal nasal deviations. This study was
aimed to evaluate a surgical modification of the spreader graft
to augment the aesthetic and functional outcomes in open
rhinoplasty.
Patients and Methods: 24 patients (21 females, 3 males),
who were candidates for open septo-rhinoplasty, were divided
into two groups of 12 each. Group A traditional spreader
grafts were applied, while in Group B, the modified diced
inverted Y shaped spreader graft was used. Clinical assessments
aided with photography were done at 3, 6 and 12 months postoperatively
together with CT-scan (6 months), and subjective
questionnaires to assess the aesthetic and functional end
results.
Results: The pre-and post-operative calculations made
for the minimal cross sectional area at internal valve level
using CT-scan showed there was mild significant changes in
Group A more than the Group B (p-values=0.0010). In the
Group A, there was an increase in the minimal cross sectional
area at the level of the internal valve by more in Group A by
+0.023cm2, while in Group B it was +0.019cm2, respectively.
The patient satisfaction of the aesthetic results it was
highest (86%) in Group A, but high (57%) in Group B. In
addition, the procedure also clinically revealed a significant
improvement in nasal obstruction in Group A (71%) and
improvement in Group B (43%).
Therefore, there was improvement of functional outcomes
if spreader graft was used, with more aesthetic improvement
if modified spreader graft is used.
Conclucion: Modified spreader graft is an applicable,
simple technical modification in spreader graft that could
improve the aesthetic and functional outcomes in open septorhinoplasty.

Keywords

Main Subjects

Aesthetics

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