Evaluation of the use of Different Spreader Techniques in Primary Open Septorinoplasty in Terms of Nasal and Olfactory Functions

Abstract

Background: In this study, the authors aimed to investigate the use of spreader and determine the efficacy and superiority of different spreader techniques in septorhinoplasty in terms of nasal and olfactory functions. Methods: A total of 60 patients who had undergone septorhinoplasty with the open technique were included in the study. In addition to open septorhinoplasty, 20 patients also underwent bilateral spreader graft placement and 20 bilateral spreader flap placement. For the remaining 20 patients, open septorhinoplasty was performed without spreader grafts or flaps. The patients completed the Nasal Obstruction Symptom Evaluation (NOSE) scale consisting of five questions, and the Brief Smell Identification Test was used to detect olfactory dysfunction. Results: The preoperative mean NOSE score of all patients was 10.87 (1-18), while the postoperative mean value was 1.83 (0-10). The preoperative mean olfactory score was 6.23 AE 2.20 in all patients while it was 7.33 AE 1.75 postoperatively. There was a statistically significant difference between the preoperative and postoperative NOSE and olfactory scores in all patients, but no statistically significant difference was observed between the three groups. Conclusion: Spreader graft or flap techniques used in septorhinoplasty are safe in terms of nasal obstruction and olfactory function, and there is no statistically significant difference between them.

Comparative Functional Effect of Alternative Surgical Techniques Used in Rhinoplasty

“…This investigation demonstrated that bilateral spreader grafts produce a significantly higher increase of PNIF when compared to spreader flaps, to a combination of spreader flaps plus a unilateral spreader graft or to none of these (Figure 1). Though being expected from their effect on nasal valve widening, the functional role of spreader grafts has not consensus, with some studies demonstrating an improvement of nasal breathing [30][31][32] while other studies could not demonstrate consistent functional benefits. 20,[33][34][35][36] Modifications of spreader grafts have been proposed to improve their functional effect 37,38 and additional techniques, such as the flaring suture 39 or the splay graft 40 have been suggested for the same purpose.…”

“…Zeid et al 41 compared nasal airway resistance before and after rhinoplasty using spreader flaps or spreader grafts and concluded that both techniques decreased nasal airway resistance without significant difference between the 2 techniques. Sowder et al 42 and Bilgin et al 31 also compared the functional effect of spreader flaps and spreader grafts using NOSE score and found no significant difference between the 2 techniques. The results of our investigation do not corroborate these studies, as the functional effect of spreader grafts was significantly higher than the effect of spreader flaps.…”