Volume 131, Issue 4 pp. 765-772
Original Report

Patient-Perceived Nasal Appearance After Septorhinoplasty With Spreader Versus Extended Spreader Graft

Rachel E. Weitzman MS

Rachel E. Weitzman MS

Department of Otolaryngology–Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A.

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Shekhar K. Gadkaree MD

Shekhar K. Gadkaree MD

Department of Otolaryngology–Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A.

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Natalie S. Justicz MD

Natalie S. Justicz MD

Department of Otolaryngology–Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A.

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Robin W. Lindsay MD

Corresponding Author

Robin W. Lindsay MD

Department of Otolaryngology–Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A.

Send correspondence to Robin W. Lindsay, MD, Department of Otolaryngology–Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114. E-mail: [email protected]Search for more papers by this author
First published: 04 August 2020
Citations: 10

Editor's Note: This Manuscript was accepted for publication on July 3, 2020.

The authors have no funding, financial relationships, or conflicts of interest to disclose.

This work was to be presented at the Triological Soeitciety 123rd Annual Meeting at COSM, Atlanta, Georgia, U.S.A., April 24–25, 2020 (meeting canceled).

Abstract

Objectives/Hypothesis

Standard spreader grafts (SSGs) are commonly used in septorhinoplasty to treat internal nasal valve narrowing and have been shown to improve nasal airway obstruction. Extended spreader grafts (ESGs) have also been proven effective for correcting nasal deviation. To date, the effectiveness of ESGs using patient-reported outcome measures has not been demonstrated, and results of ESGs have not been compared to SSGs. This study aims to assess satisfaction and nasal appearance in patients who have undergone septorhinoplasty with SSG versus ESG.

Study Design

Prospective cohort study.

Methods

Five hundred sixty-eight patients who underwent septorhinoplasty with SSGs and 126 patients who underwent septorhinoplasty with ESGs between 2012 and 2018 were administered the Nasal Obstruction Symptom Evaluation (NOSE) scale and FACE-Q Satisfaction With Nose, FACE-Q Satisfaction With Nostrils, and FACE-Q Social Functioning scales pre- and postoperatively. Pre- and postoperative NOSE and FACE-Q scores, negative inspiratory force (NIF), and changes in these values were compared between groups.

Results

Results demonstrated clinically and statistically significant improvement at follow-up for both groups. There was no significant difference between the SSG and ESG groups in mean improvement of NOSE scores, FACE-Q scores, and NIF at follow-up of 6 months and at 12 months.

Conclusions

This study demonstrates that SSGs and ESGs both provide clinically and statistically significant improvement, and no significant difference in functional outcome. Both techniques can be effective. The etiology of the nasal obstruction and/or deformity should be considered when deciding which type of spreader graft to use.

Level of Evidence

3 Laryngoscope, 131:765–772, 2021

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