Oblique Septal Crossbar Graft for Anterior Septal Angle Reconstruction

Aziz, Zeeshan S.; Brenner, Michael; Putman, Harrison C.

doi:10.1001/archfacial.2010.92

Cited by 9 publications

(13 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is heavily emphasized in rhinoplasty and nasal reconstructive surgery literature that the dorsal and caudal septum L‐strut provide structural stability to the nose as part of the critical regions for nasal support . Deformities or deficiencies in this region can create aesthetic and functional problems such as saddle nose deformity, malpositioned tip, twisted nose, and internal valve insufficiency; therefore, elevated collagen in the caudal regions as well as increased collagen to sGAG ratios in the dorsal regions of the nasal septum as reported in this study support the hypothesis that this region would also provide greater stability and support, and tends to scientifically substantiate the value of the L‐strut preservation.…”

Section: Discussionsupporting

confidence: 80%

A compositional analysis of cadaveric human nasal septal cartilage

et al. 2013

View full text Add to dashboard Cite

Objectives 1) To localize quantitatively the major biochemical constituents of native adult human septal cartilage across whole septa. Study Design Prospective, basic science Methods The nasal septa from seven cadavers were partitioned into 24 separate regions: six from caudal to cephalic and 4 from dorsal to ventral. Biochemical assays were used to determine the quantities, relative to wet weight, of the major constituents of cartilage: chondrocytes, collagen and sulfated glycosaminoglycan. Results On average, each milligram of wet cartilage contained 24,900 cells, 73.9 micrograms collagen, and 17.1 micrograms sulfated glycosaminoglycan. Cell number showed no significant variation across the septa. In contrast, the caudal regions of the septa were associated with higher levels of collagen, the ventral regions correlated with higher levels of sulfated glycosaminoglycan, and the dorsal regions were associated with an elevated ratio of collagen to sulfated glycosaminoglycan. Conclusion This study represents the first characterization of the biochemical composition of native human septal cartilage across whole septa. Quantities of collagen and sulfated glycosaminoglycan showed region-specific variation across the septum. The localized pattern of collagen and sulfated glycosaminoglycan deposition are consistent with the significance of preserving the “L-strut” during rhinoplasty and other nasal reconstructive procedures. In addition, it may assist in defining design goals for tissue-engineered septal neocartilage constructs to meet specific reconstructive needs in the future. Level of Evidence N/A

show abstract

Section: Discussionsupporting

confidence: 80%

A compositional analysis of cadaveric human nasal septal cartilage

et al. 2013

View full text Add to dashboard Cite

show abstract

“…However, the use of spreader grafts involves some potential risks. Removal of the grafts may potentially weaken the stability of the septum, and implanted spreader grafts may be displaced and visible in the dorsum of the nose 20,21 . In addition, a graft of sufficient length may not be possible in patients who have undergone septoplasty previously.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Functional Outcomes of an Autospreader Flap and Spreader Graft in Rhinoplasty

Aydoğdu¹,

Bayram²,

Aydoğdu

2022

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

Objective: Nasal obstruction after rhinoplasty occurs due to narrowing of the internal nasal valve. Narrowing is due to osteotomy performed to close the open roof of nose after dorsum hump resection. Spreader grafts and autospreader flaps are used to prevent such narrowing. in this study, we aimed to compare the effects of these 2 rhinoplasty techniques on olfactory function, nasal air passage opening, quality of life, and patient satisfaction.Methods: In this prospective study, 48 rhinoplasty patients were randomly divided into 2 groups according to graft technique used, either spreader graft or autospreader flap. These 2 groups were compared for patient satisfaction. The sinonasal outcome test-22, peak nasal flowmetry, and Connecticut Chemosensory Clinical Research Center test were applied to all patients before and 8 weeks after surgery. Results: The study enrolled 48 patients. Nasal airflow increased in both groups postoperatively. in the preoperative and postoperative comparison of odor functions, postoperative odor functions were similar in both groups. In the autospreader flap group, the preoperative rhinoplasty outcome evaluation questionnaire score was 4.1 AE 2.2 versus 21.3 AE 2.6 in the third postoperative month. The preoperative rhinoplasty outcome evaluation score was 3.9 AE 2.1 in the spreader graft group and 19.7 AE 1.9 in the third postoperative month.Conclusions: In the present study, postoperative nasal airflow improved in the patients in both the spreader graft and autospreader flap groups. in the patient satisfaction surveys after rhinoplasty, the satisfaction of the patients in the autospreader flap group was higher than that of the patients in the spreader graft group.

show abstract

“…21 Elaborate strategies to prevent warping include harvest of bone graft and reinforcement with Kirschner wires, laminate construction, microplates, chimeric autologous graft, or crossbar grafts. 10,11,13,15,22,23 The authors feel that a simpler approach is to fixate the dorsal strut at a second point. The pi graft was designed with a structural engineer's mindset: the second strut is intended to (1) reduce the moment arm on the nasal-graft junction and (2) provide a third point of fixation, on the opposite side of the caudal strut, to minimize lateral warping.…”

Section: Discussionmentioning

confidence: 99%

“…To address this, Aziz et al reinforced an L-shaped strut with an oblique crossbar. 15 The team did not compare outcomes against traditional methods but did remark that there was no airway obstruction or persistent deformity in any of the cases. More traditional approaches include paired extended spreader grafts (ESGs) and one or more septal extension grafts (SEGs) that are bolstered to the anterior nasal spine (ANS).…”

mentioning

confidence: 99%

The Pi Graft for Correction of Severe Saddle Nose Deformity

Zelken¹,

Chang

Hsiao

2016

Facial plast Surg

View full text Add to dashboard Cite

Saddle nose deformity is challenging because there is both aesthetic and functional compromise, and high rates of recurrence have been reported. Autologous costal cartilage is the widely preferred medium for reconstruction, but there may be room for improvement in the configuration of the cartilage struts. The pi graft is stabilized at two points, proximally and distally, distinguishing it from the traditional L-strut. Indications include severe (Types III and IV) saddle nose deformity with collapse of the mid-vault, and recurrence after prior reconstruction. Costal cartilage is harvested and three struts are crafted to make the foundation layer: a dorsal strut, caudal strut, and mid-vault strut. An aesthetic layer is composed of a carefully crafted dorsal graft and tip graft. Three men and 11 women were treated from 2013 to 2015 using this method for severe saddle nose deformity. Aesthetic and functional outcomes were evaluated. Patients were followed up for 12 months (range, 8-14 months). There was no recurrence of deformity or warping of the aesthetic or foundation layers. All patients were guided to anticipate refinement of the tip at 3 months to ease the burden on the skin envelope in stage I, but only five patients (35.7%) opted for it, as the remaining patients were satisfied with their appearance. The pi graft is a composite reconstructive method that is designed to minimize warping and recurrence of the saddle nose deformity. This method was successful in this series, although objective comparisons with traditional methods were not made.

show abstract

Oblique Septal Crossbar Graft for Anterior Septal Angle Reconstruction

Cited by 9 publications

References 17 publications

A compositional analysis of cadaveric human nasal septal cartilage

A compositional analysis of cadaveric human nasal septal cartilage

Assessment of Functional Outcomes of an Autospreader Flap and Spreader Graft in Rhinoplasty

The Pi Graft for Correction of Severe Saddle Nose Deformity

Contact Info

Product

Resources

About