The Effect of Spreader Graft and Mattress Suture Technique on Rhinoplasty in Patients With Nasal Hump Smaller Than 3 mm

Abstract

Introduction: Rhinoplasty is a common plastic surgery that potentially has some complications such as postoperative deformities and breathing problems. A humpy nose is among the main reasons for rhinoplasty. Nasal valve (the narrowest part of the nasal airway) collapse may be occurred after nasal hump removal. Spreader graft is essential after more than 3 mm nasal hump removal. But the value of this graft is unknown for patients with nasal hump smaller than 3 mm. Mattress suture is another technique for widening the nasal valve angle. This study compares the effects of spreader graft and mattress suture technique on postoperative deformity and nasal valve patency in patients with nasal hump smaller than 3 mm as compared with control group (no graft and suture). Methods: In this clinical trial study 210 patients who underwent rhinoplasty with 2 different techniques involved. Their postoperative deformity and nasal valve patency were evaluated by subjective (questionnaire and digital photography) method before and after rhinoplasty during 6 months follow-up. Results: Statistically, nasal obstruction had no significant difference before and after rhinoplasty and no significant difference was observed between spreader graft and mattress sutures (P > 0.05), but significantly better results than control group (P < 0.05). Conclusion: In this study the results of nasal valve patency of 2 techniques were similar. Because of several considerations in spreader graft technique such as needing to septoplasty in this technique even in patients without septal deviation that causes longer surgical duration, excessive blood loss, it is recommended to use Mattress suture in patients with nasal hump smaller than 3 mm.

Surgical Treatment of Dynamic Nasal Collapse

“…4 ). 56 Clocking sutures may also be used to drive the midvault away from where it is deviated. 57 The advantage of the open approach is improved visualization and easier stabilization of the spreader grafts.…”

“…54,55 The ULC is separated from the cartilaginous septum. 56 The spreader graft is then placed submucosally between the ULC and dorsal septum to cantilever the ULC. 5 A mattress suture through both grafts and the dorsal edge of the cartilaginous septum may be placed.…”

Proposal for Perioperative Pharmacological Protocol for the Reduction in Early Complications in Orthorhinoseptoplasty: Five Years of Experience

“…Technical complications include septal perforation, saddle nose deformity, open roof deformity, inverted V deformity, pollybeak deformity, and rocker deformity (these depend on technique rather than management related to osteotomy and other procedures). There are numerous clinical studies that have examined the effects of some medical applications [ 4 , 8 , 9 ], surgical techniques [ 10 , 11 ], and preoperative and postoperative medications [ 12 , 13 , 14 , 15 ] to minimize these complications, but there is not yet a standardized protocol. In the absence of standardized definitions of complications and treatment protocols, comparison of complication rates between different studies is extremely difficult, and the ability to perform high-quality meta-analyses is limited.…”