A new approach for crooked nose: Separated spreader graft “puzzle graft”

Uzun, Selami; Keskin, Serhan; Kavvasoğlu, Cem

doi:10.1016/j.amjoto.2021.103335

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…It may be also not be applicable for crooked nose cases that require stronger cartilage support to straighten the nasal dorsum. In cases of saddle and crooked noses, more enduring cartilage grafts may be necessary to ensure sufficient septal support [3,16,32]. In this case, providing thinner nasal dorsum may be sacrificed to ensure sufficient septal support.…”

Section: Discussionmentioning

confidence: 99%

Dorsocaudal reconstruction of previous caudal septal resections with partial split spreader graft

Ekinci

Can

Koçman³

2022

J Surg Med

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Background/Aim: Nasal obstruction is caused mainly by nasal septal deviation, and submucosal resection is usually performed to treat this problem. However, if over-resected, nasal tip deprojection, deprojection of the dorsum, or pseudo-hump formation may be seen. Spreader grafts are used to restore the nasal septum in these cases, and different techniques have been described for this restoration; however, these techniques may not be the best fit for such restoration. This study presents a novel and effective method for septal reconstruction in patients with previous septal resections. Methods: Between March 2012 and October 2014, a case series of 14 male patients with tip deprojection and pseudo-hump formation who had undergone corrective surgery in our clinic was retrospectively examined. Partial-split, caudal extension costal spreader grafts were used and were fixed to the dorsum of the remnant septum cranially to prevent warping while avoiding nasal dorsum widening. Pre- and post-operative comparisons were performed, and the Nasal Obstructive Symptoms Evaluation questionnaire for the functional results and subjective Esthetic Appearance test for the esthetic outcomes were administered. Results: The mean age was 36.8 years (19–56 years), and the mean follow-up time was 14.6 months. Functional outcomes and esthetic appearance led to significantly improvements in all post-operative categories (P < 0.05) without any major complications. Common complaints were usually the same as seen in conventional rhinoplasty procedures, such as facial swelling, nasal stuffiness, pain, and/or epistaxis. None of the patients requested revision surgery. Conclusion: Using partial-split, caudal extension costal spreader grafts in the reconstruction of dorsocaudal septum in patients with previous septal resections appears to provide favorable functional and esthetic results.

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Section: Discussionmentioning

confidence: 99%

Dorsocaudal reconstruction of previous caudal septal resections with partial split spreader graft

Ekinci

Can

Koçman³

2022

J Surg Med

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“…4 Bilateral spreader grafts were advocated by some authors to support the INV on both sides and to strongly counter the cartilaginous memory of the dorsal part of the cartilaginous nasal septum. [5][6][7] Many modifications have been designed on the spreader grafts to be more effective in the management of the crooked nose deformity, such as the extended spreader graft, 8 the cross-spreader graft, 9 the separated spreader graft "puzzle graft," 10 and the septal crossbar graft. 11 The aim of this study is to evaluate the effect of using a unilateral convex spreader graft in the correction of the C-shaped crooked nose deformity when it is placed against the convex side of the deviated dorsal part of the cartilaginous nasal septum after releasing the other extrinsic and intrinsic forces that are responsible for the nasal deviation.…”

mentioning

confidence: 99%

“…Many modifications have been designed on the spreader grafts to be more effective in the management of the crooked nose deformity, such as the extended spreader graft, 8 the cross-spreader graft, 9 the separated spreader graft “puzzle graft,” 10 and the septal crossbar graft 11 …”

mentioning

confidence: 99%

The Use of a Unilateral Curved Spreader Graft in the Management of Crooked Nose Deformity

Elsayed,

Elbahrawy,

Sorour

et al. 2023

Ann Plast Surg

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Aim of Work The aim of this study is to present a new technique of using spreader grafts in the correction of crooked nose deformity with C-shaped deviation of the middle third of the nose. Patients and Methods This is a prospective case series study conducted on 18 patients with crooked nose deformity with C-shaped deviation of the middle third of the nose. All of the patients were managed by open septorhinoplasty. During surgery, a curved spreader graft was harvested from the nasal septum and placed on the convex side of the C-shaped deviation of the dorsal part of the nasal septum. Objective measurements of the angles of external nasal deviation (END) and the internal nasal valve (INV) angles were performed before and 6 months after the surgery. Subjective assessment of aesthetic satisfaction by the visual analog scale and nasal function by the nasal obstruction symptom evaluation scale was also performed before and 6 months after surgery. Results Eighteen patients were enrolled in the study and completed the minimum follow-up period of 6 months. The mean follow-up period was 17.3 months. Objectively, there was highly significant (P < 0.00001) improvement of the END angle and INV angle. Subjectively, there was also highly significant (P < 0.00001) improvement of both the nasal obstruction symptom evaluation score and the visual analog scale score for aesthetic satisfaction. Conclusions The insertion of a curved unilateral spreader graft over the convexity of the deviated nasal dorsum can correct the END, improve the collapsed INV on both sides, and consequently achieve satisfactory aesthetic and functional outcomes.

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Nasal axis lateralization suture technique in crooked nose

Erdim,

Akcan

2024

Eur Arch Otorhinolaryngol

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A new approach for crooked nose: Separated spreader graft “puzzle graft”

Cited by 3 publications

References 13 publications

Dorsocaudal reconstruction of previous caudal septal resections with partial split spreader graft

Dorsocaudal reconstruction of previous caudal septal resections with partial split spreader graft

The Use of a Unilateral Curved Spreader Graft in the Management of Crooked Nose Deformity

Nasal axis lateralization suture technique in crooked nose

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