Objective Comparison Between Spreader Grafts and Flaps for Mid-Nasal Vault Reconstruction: A Randomized Controlled Trial

Abstract

Objective: The goal of rhinoplasty is not exclusively aesthetic and the nasal function should always be considered. Several rhinoplasty techniques can participate in nasal valve dysfunction (eg, dorsal hump reductions). Therefore, mid-nasal vault reconstruction by spreader grafts or flaps is mandatory in these cases. To date, there is a literature gap in comparing both techniques objectively. This study shows an objective comparison between spreader grafts and flaps for mid-nasal vault reconstruction. Material and Methods: This study was a double-blind randomized controlled trial including 40 patients who were randomly divided into 2 groups. Group 1 (20 patients) underwent spreader grafts insertion, whereas group 2 (20 patients) underwent spreader flap placement technique. Pre-operative active anterior rhinomanometry measurements were compared to 6-month post-operative measurements. Data were summarized as mean (standard deviation) for the quantitative variables. Comparisons between the 2 groups were done using unpaired t test. Results: In both groups, a significant decrease in nasal resistance was noted in both the right and left sides 6 months post-operatively ( P < .001). However, the comparison between the 2 both groups showed no statistical significance. Conclusion: Both spreader grafts and flaps, which are used for the mid-nasal vault reconstruction, have comparable and effective results in reducing the nasal resistance as evidenced by active anterior rhinomanometry measurements.

Role of spreader flaps in primary rhinoplasty, functional and aesthetic outcomes: a systematic review

“…Inhalation FR on the left side and exhalation NAR on the right side were significantly reduced postoperatively in the SG group (p=0.025 and p=0.04, respectively). Finally, in the Ζeid et al study (25) , a statistically significant reduction in NAR, on the right and left sides, was observed six months postoperatively in both groups (SF and SG; p<0.001), with no significant difference between them.…”

“…In four studies (19,20,24,25) , rhinomanometry was used. Görgülü et al (19) showed a significant decrease in both inhalation and exhalation nasal airway resistance (NAR; p<0.001) by using an active anterior rhinomanometry.…”

“…The NOSE questionnaire was used as one of the basic subjective methods for evaluating BFI in eight (12,14,15,16,18,(21)(22)(23) of the 13 studies (12)(13)(14)(15)(16)(18)(19)(20)(21)(22)(23)(24)(25) . Specifically, all studies noted an improvement in breathing function.…”

“…Thirteen studies fulfilled the inclusion criteria (12)(13)(14)(15)(16)(18)(19)(20)(21)(22)(23)(24)(25) . Of these, three were randomised controlled trials (RCTs), three were clinical trials (randomised or not), five were prospective studies and two were retrospective studies.…”

“…The BFI was measured in all 13 included studies (12)(13)(14)(15)(16)(18)(19)(20)(21)(22)(23)(24)(25) by using objective and subjective methods (Table 2).…”