A Cadaveric Study Comparing the Efficacy of the Sheen Spreader Graft and the Fulcrum Spreader Graft

Gwanmesia, Ivo; Couto, Rafael A.; Papay, Francis

doi:10.1097/prs.0000000000001578

Cited by 7 publications

(6 citation statements)

References 14 publications

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“…The thickness of the spreader grafts can be modified helping to reshape the middle third and keep the brow-tip aesthetic lines. 27,28 This has recently been one of my favorite techniques in rebuilding the middle vault. Besides, I can still use spreader grafts under the intact middle third for splinting the existing deviations and splinting the caudal septal extension grafts.…”

Section: Spreader Flapsmentioning

confidence: 99%

Rebuilding the Middle Vault in Rhinoplasty: A New Classification of Spreader Flaps/Grafts

Apaydın

2016

Facial plast Surg

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After hump removal in reduction rhinoplasty, one of the main steps is to rebuild the middle vault. Spreader grafts have long been the main tool for the surgeon. Within the last two decades, the spreader flaps have started to be very popular as well. In accordance with the experience and technical preferences of the surgeon, there are many different options. In this article, the spreader grafts are classified as traditional, modified, splinting, and reconstructive. The spreader flaps are designed in accordance with their relationship with the septum and the spreader grafts.

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Section: Spreader Flapsmentioning

confidence: 99%

Rebuilding the Middle Vault in Rhinoplasty: A New Classification of Spreader Flaps/Grafts

Apaydın

2016

Facial plast Surg

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“…Described by Sheen in 1984 [ 33 ], the spreader graft is considered a well-established technique to improve the internal vault. It not only improves the angle between septum and superior lateral cartilages but also improves the aesthetic appearance of the nasal dorsum “eyebrow-nasal tip lines” [ 5 , 6 , 34 ]. Initially, the spreader graft was described to correct the inverted “V” deformity caused by large osteocartilaginous dorsum removal [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

“…According to the Bernoulli principle [ 5 ], reduced pressure is transmitted to the lateral walls during inspiration, thereby narrowing the internal nasal vault. Air passing through the nasal vaults at high speed lowers intraluminal pressure, producing an inspiratory collapse [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

“…One of the greatest challenges in rhinoplasty is maintaining endonasal integrity and functional nasal vault activity [ 5 , 6 ]. The endonasal vaults are the narrowest part of the airway.…”

Section: Introductionmentioning

confidence: 99%

“…The endonasal vaults are the narrowest part of the airway. These structures are defined by the junction between the septum and the caudal superior lateral cartilages, forming an angle of 10–15° in Caucasians (leptorrhine) and a larger angle in people of African and Asian heritage (platyrrhine) [ 5 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Alar cartilage—an alternative for spreader graft in primary rhinoplasty

Uebel

Matta

2017

Eur J Plast Surg

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BackgroundAlar cartilage can be very useful for tip and dorsum grafts. Depending on its size and thickness, it can be an important alternative for spreader grafts to improve endonasal functional deficiencies, correct deviated noses, and prevent inverted “V” deformities. Caucasian patients with bulbous tips are the most common candidates to achieve such benefits. It is easy to obtain and to frame into a desired graft.MethodsThe authors describe a surgical technique using the alar cartilages as spreader grafts. All Caucasian patients with bulbous tips who underwent primary rhinoplasty were included. All patients have been evaluated after 3 to 4 months and after 1 and 2 years by aesthetical and functional criteria.ResultsThirty-four patients (28 female and 6 male) underwent this procedure between 2001 and 2015: 94% reported a better airflow, 91% reported very good aesthetic results and were very satisfied 2 years postoperatively, and 12% had nasal deviations that were corrected with a one side double-layered spreader grafts. Two patients presented supra-tip deformities and one patient had a columella scar that was revised surgically. No cases of inverted “V” deformity were reported 2 years postoperatively.ConclusionsPatients with functional satisfaction and with a straight and smooth dorsum seem to be the most important benefits that were achieved with this technique using alar cartilage spreader grafts, an alternative that can be offered to improve airflow and to prevent deviated and inverted “V” deformities.Level of Evidence: IV, therapeutic study.

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Management of the Mid-vault

Bi̇çer

Bilkay

Bılkay

2019

All Around the Nose

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A Cadaveric Study Comparing the Efficacy of the Sheen Spreader Graft and the Fulcrum Spreader Graft

Abstract: The fulcrum spreader graft technique may be a more effective technique for middle vault reconstruction compared with the Sheen spreader graft technique.

Cited by 7 publications

References 14 publications

Rebuilding the Middle Vault in Rhinoplasty: A New Classification of Spreader Flaps/Grafts

Rebuilding the Middle Vault in Rhinoplasty: A New Classification of Spreader Flaps/Grafts

Alar cartilage—an alternative for spreader graft in primary rhinoplasty

Management of the Mid-vault

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