Abstract

Background: The ‘anterior spreader flap’ or auto-spreader flap is a new minimally invasive technique, for the treatment of nasal valve insufficiency or stenosis and can be used as an alternative technique for spreader grafts. This study was done to compare between the spreader graft and auto-spreader flap in open approach reduction rhinoplasty regarding postoperative clinical airway, operative time as well as the aesthetic outcomes.

Methods: 32 Patients were randomly allocated into group (A): Open reduction rhinoplasty for hump removal with spreader grafts and group (B): Open reduction rhinoplasty for hump removal with auto-spreader flaps.

Results: Thirty two patients were 14 males (43.75%) and 18 females (56.25%). Regarding the operative time, the auto-spreader flap was shorter in operative time in comparison to the spreader graft. The mean duration of operation in auto-spreader flap was 49.2 minutes ± 10.8, while it was 91.1 minutes ± 12.1 in spreader graft. The difference between the two procedures was highly statistically significant (P = 0.001). According to the line of treatment, there was a great improvement in the patients' symptom of nasal obstruction according to NOSE scale either treated by spreader graft or auto spreader flap. Despite of this improvement of nasal obstruction, it was statistically insignificant either after three or six months postoperative (P > 0.05). Irrespective of the surgical procedures done in this study; either spreader grafts or auto-spreader flaps, the overall aesthetic satisfaction was about 60% (19 of 32). Only 18% (6 of 32) experienced unsatisfactory results and 22% (7 of 32) with mild or partial satisfaction. Regarding aesthetic outcome according to the line of treatment, it was found that 81.3% of patients treated by spreader graft (group A) were satisfied, and 12.5% reported mild improvement. Only one case (6.3%) was reported with unsatisfactory aesthetic outcomes. In group (B), treated by auto spreader flap, 37.5% of patients were satisfied, 31.3% mild improvement and 31.3% experienced unsatisfactory results. The difference between two groups was statistically significant (P = 0.038).

Conclusion: This difference between both groups concluded that spreader graft has better aesthetic outcomes in comparison with auto spreader flap. However, both are very effective line of treatment regarding the nasal obstruction at the area of nasal valve.

Keywords: Septorhinoplasty; Spreader Graft; Auto-Spreader Flap; Nasal Obstruction

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Citation

Citation: Eldeeb W., et al. “A Comparative Study of Open Septorhinoplasty with Spreader Graft and Auto-Spreader Flap in Patients with Nasal Obstruction". Acta Scientific Otolaryngology 2.6 (2020): 20-28.

Copyright

Copyright: © 2020 Eldeeb W., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.