Spreader grafts in der Septorhinoplastik

Wagner, W.; Schraven, Sebastian P.

doi:10.1055/s-0030-1270471

Cited by 15 publications

(9 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The importance of maintaining a nasal valve and reconstructing the middle nasal vault immediately following hump reduction is now widely recognized among rhinoplasty experts. [1][2][3][4][5][6][7][8][9][10][11][12] The groundwork was laid by Sheen, 4 who first advocated spreader grafts for middle vault stabilization and contour enhancement. However, the more recent advent of spreader flaps has added a second option for middle vault reconstruction following hump reduction in select patients.…”

Section: Introductionmentioning

confidence: 99%

Options for Middle Vault and Dorsum Restoration after Hump Removal in Primary Rhinoplasty

Kovačević¹,

Riedel²,

Göksel

et al. 2016

Facial plast Surg

View full text Add to dashboard Cite

Prevention of unfavorable sequelae following humpectomy in reduction rhinoplasty by restoration of the middle nasal vault complex today has become imperative in the majority of patients with perhaps the exception of small humps. In general, the techniques used for preservation and reconstruction of these important anatomical structures can be divided into two main categories: spreader graft and spreader flap techniques. Oversimplified spreader graft techniques require donor cartilage, whereas spreader flap techniques use the excess height of the medial portion of the upper lateral cartilages in patients with a cartilaginous hump. In principle, both donor cartilage and preserved upper lateral cartilages usually are positioned along both sides of the dorsal septum to provide natural and harmonious contours as well as to avoid functional impairment (valve collapse). However, the considerable number of publications on this topic attests to existing downsides of both surgical principles. To overcome these shortcomings, we illustrate additional modifications in the application of spreader grafts as well as spreader flaps. However, the main goal of this article is to provide an algorithm helping to decide which technique is best suited to meet the requirements of each individual patient.

show abstract

Section: Introductionmentioning

confidence: 99%

Options for Middle Vault and Dorsum Restoration after Hump Removal in Primary Rhinoplasty

Kovačević¹,

Riedel²,

Göksel

et al. 2016

Facial plast Surg

View full text Add to dashboard Cite

show abstract

“…The success of this method depends on the placement of two long and straight spreader grafts which are used as the main supportive structure of the nose. 19 Obtaining a long spreader graft may be considered a disadvantage when there is an insufficient graft source, which can be found particularly in patients who have had previous septoplasty. Additionally, in severely deviated noses, preparation of two considerably straight spreader grafts from the native septal cartilage is not always possible.…”

Section: Discussionmentioning

confidence: 99%

A New Perspective for Spreader Graft Use in Severely Deviated Septum: Is Septal Continuity an Obligation for a Stable and Straight Nasal Septum?

2016

View full text Add to dashboard Cite

Severe septal deviation is a challenging deformity usually treated using aggressive surgical methods, and extracorporeal septoplasty (ECS) is a commonly used method for this issue. However, this method has severe risks and complications such as the recurrent deformity or nasal saddling. In this article, we present an alternative solution to ECS procedure for the correction of severe septal deviation. Sixteen patients with severe c- or s-shaped septal deviation with a mean age of 26.5 years were included in the study. The entire deviated part of the septal cartilage was resected as a vertical block creating a full-thickness defect between the most cranial and caudal parts of the septal cartilage. After that, two spreader grafts were placed bilaterally facilitating the septal integrity and leaving the full-thickness septal defect unchanged. The surgical results were evaluated using the preoperative and postoperative facial photographs and patient satisfaction was determined using nine relevant questions of DAS-59 scale. The only complication observed in the follow-up period of 19 months was hanging columella deformity which was corrected at the postoperative first year. The mean length of the resected septal segment was 12.4 mm. The mean length of the resultant septal cartilage defect after the vertical resection was 5.9 mm. The mean length of the placed spreader grafts was 25.6 mm. The comparison of the preoperative and postoperative photographs showed significant improvement of the nasal contour and considerable correction of the septal deviation. The statistical evaluation of the answers given to the questions of the DAS-59 scale clearly demonstrates that a significant degree of patient satisfaction was achieved. Severe septal deviation may be successfully corrected by full-thickness resection of the deviated part and reconstruction with bilateral spreader grafts with a low risk of postoperative complications.

show abstract

“…However, this technique is also associated with a widening of the columella. Generally, intracorporeal septoplasty is often inadequate to address severe septal deformities; in these cases cartilage grafts 16,17 may be effective in straightening the septum. The main point of criticism of the grafting techniques is the tendency for the overlapping grafts to widen the caudal septum and narrow the internal and the external nasal valve.…”

Section: Discussionmentioning

confidence: 99%

“…The batten grafts are then tied along the weakened cartilage to stabilize it in the corrected position. The placement of spreader grafts between the upper lateral cartilage and the caudal septum may also effectively stabilize the cartilage (Figures 6 and 7, right) 17 . The approach introduced by Kridel (Figure 8) for the management of caudal septal deviation involves the cephaloposterior advancement of the medial crura of the lower lateral cartilages onto the caudal septum 18 .…”

Section: Intracorporeal Septoplastymentioning

confidence: 99%