Acta Scientific Otolaryngology (ASOL)

Research Article Volume 2 Issue 6

A Comparative Study of Open Septorhinoplasty with Spreader Graft and Auto-Spreader Flap in Patients with Nasal Obstruction

Naguib MB, Rifaat M, Madian YT, Elnahriry T and Eldeeb W*

Department of Otolaryngology, Head and Neck surgery, Suez Canal University, Egypt

*Corresponding Author: Eldeeb W, Department of Otolaryngology, Head and Neck surgery, Suez Canal University, Egypt.

Received: April 19, 2020; Published: May 30, 2020

×

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

×

References

  1. Daniel Y. “Functional and aesthetic effects of spreader grafts technique in rhinoplasty”. Scripta Scientifica Medica1 (2014): 68-73.
  2. Samaha M and RassouliA. “Spreader graft placement in endonasal rhinoplasty: Technique and a review of 100 cases”. Plastic Surgery 4 (2015): 252-254.
  3. Sheen JH. “Spreader graft: a method of reconstructing the roof of the middle nasal vault following rhinoplasty”. Plastic and Reconstructive Surgery 2 (1984): 230-239.
  4. Rohrich RJ and Ghavami A. “Rhinoplasty for middle eastern noses”. Plastic and Reconstructive Surgery 123 (2009): 1343-1354.
  5. Hassanpour SE., et al. “Comparison of Aesthetic and Functional Outcomes of Spreader Graft and Autospreader Flap in Rhinoplasty”. World Journal of Plastic Surgery 2 (2016): 133-138.
  6. Zojaji R., et al. “Quality of life in patients who underwent rhinoplasty”. Facial Plastic Surgery 30 (2014): 593-596.
  7. Bessler S., et al. “Anterior spreader flap technique: a new minimally invasive method for stabilizing and widening the nasal valve”. Journal of Plastic, Reconstructive and Aesthetic Surgery12 (2015): 1687-1693.
  8. Gruber RP., et al. “The spreader flap in primary rhinoplasty”. Plastic and Reconstructive Surgery 6 (2007): 1903-1910.
  9. Byrd HS., et al. “Using the autospreader flap in primary rhinoplasty”. Plastic and Reconstructive Surgery 119 (2007): 1897-1902.
  10. Oneal RM and Berkowitz RL. “Upper lateral cartilage spreader flaps in rhinoplasty”. Aesthetic Surgery Journal 18 (1998): 370-371.
  11. FomonS and Caron A. “Collapsedala”. Acta Oto-Laryngologica, 51 (1950): 465-484.
  12. Yoo S and Most SP. “Nasal airway preservation using the autospreader technique. Analysis of outcomes using a disease-specific quality of life instruments”. Archives of Facial Plastic Surgery 4 (2011): 231-233.
  13. Lipan MJ and Most SP. “Development of a severity classification system for subjective nasal obstruction”. JAMA Facial Plastic Surgery 5 (2013): 358-361.
  14. Stewart MG., et al. “Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale”. Otolaryngology–Head and Neck Surgery 2 (2004): 157-163.
  15. Lam DJ., et al. “Comparison of anatomic, physiological, and subjective measures of the nasal airway”. The American Journal of Rhinology 5 (2006): 463-470.
  16. Stewart MG., et al. “Outcomes after nasal septoplasty: results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) study”. Otolaryngology–Head and Neck Surgery 3 (2004): 283-290.
  17. Most SP. “Analysis of outcomes after functional rhinoplasty using a disease-specific quality-of-life instrument”. Archives of Facial Plastic Surgery 5 (2006): 306-309.
  18. Lerma J. “The "lapel" technique”. Plastic and Reconstructive Surgery 6 (1998): 2274-2275.
  19. Murrell GL. “Auricular cartilage grafts and nasal surgery”. Laryngoscope 12 (2004): 2092-2102.
  20. Jaykaran C and Tamoghna B. “How to Calculate Sample Size for Different Study Designs in Medical Research?”. Indian Journal of Psychological Medicine 2 (2013): 121-126.
  21. Standlee AG and Hohman MH. “Evaluating the Effect of Spreader Grafting on Nasal Obstruction Using the NOSE Scale”. Annals of Otology, Rhinology, and Laryngology 3 (2017): 219-223.
  22. Hussein WK., et al. “Modified autospreader flap for nasal valve support: utilizing the spring effect of the upper lateral cartilage”. European Archives of Oto-Rhino-Laryngology 2 (2015): 497-504.
  23. Salyer KE. “Primary correction of the unilateral cleft lip nose: a 15-year experience”. Plastic and Reconstructive Surgery 77 (1986): 558-566.
  24. Varedi P., et al. “Spreader graft placement: A simplified technique for young surgeons”. International Journal of Oral and Maxillofacial Surgery 43 (2014): 1216-1217.
  25. Saedi B., et al. “Spreader flaps do not change early functional outcomes in reduction rhinoplasty: a randomized control trial”. American Journal of Rhinology and Allergy 28 (2014): 70-74.
  26. Manavbaşı YI and Başaran I. “The role of upper lateral cartilage in dorsal reconstruction after hump excision: section 1. Spreader flap modification with asymmetric mattress suture and extension of the spreading effect by cartilage graft”. Aesthetic Plastic Surgery 35 (2011): 487-493.
  27. Rhee JS., et al. “A systematic review of patient-reported nasal obstruction scores”. JAMA Facial Plastic Surgery 3 (2014): 219-225.
  28. Most SP. “Anterior septal reconstruction: outcomes after a modified extracorporeal septoplasty technique”. Archives of Facial Plastic Surgery 3 (2006): 202-207.
  29. Andre RF., et al. “Endonasal spreader graft placement as treatment for internal nasal valve insufficiency: no need to divide the upper lateral cartilages from the septum”. Archives of Facial Plastic Surgery 1 (2004): 36-40.
  30. Gruber RP., et al. “Dorsal reduction and spreader flaps”. Aesthetic Surgery Journal 4 (2011): 456-464.
  31. Helal MZ., et al. “Effects of rhinoplasty on the internal nasal valve: a comparison between internal continuous and external perforating osteotomy”. Annals of Plastic Surgery 5 (2010): 649-657.
  32. Schlosser RJ and Park SS. “Functional rhinoplasty. Operative techniques in otolaryngology”. Head and Neck Surgery 3 (1999): 203-208.
  33. Elwany S and Thabet H. “Obstruction of the nasal valve”. The Journal of Laryngology and Otology 3 (1996): 221-224.
  34. Chambers KJ., et al. “Evaluation of Improvement in Nasal Obstruction Following Nasal Valve Correction in Patients with a History of Failed Septoplasty”. JAMA Facial Plastic Surgery 5 (2015): 347-350.
  35. Kutubidze A. “Nasal dorsal aesthetic lines and rhinoplasty technical tricks”. Plastic and Aesthetic Research 2 (2015): 315-319.
  36. Sowder JC., et al. “Use of Spreader Flaps without Dorsal Hump Reduction and the Effect on Nasal Function”. JAMA Facial Plastic Surgery4 (2017): 287-292.
×

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.




Metrics

Acceptance rate34%
Acceptance to publication20-30 days
Impact Factor0.871

Indexed In







News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is December 25, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"

Contact US