The effect of spreader flap in reconstruction of the middle vault of the nose after humpectomy

Abstract EN

This study aimed to evaluate how satisfied are those patients who underwent primary rhinoplasty to correct their humpy nose aestheticly and functionally.

In primary rhinoplasty, middle vault reconstruction of the nose is crucial step after dehumping, and for that purpose we used the spreader flap technique to regain functionality with aesthetic dorsal lines.

Eleven patients with a significant dorsal hump who underwent open rhinoplasty for the sake of aesthetic reasons, in which the middle vault was reconstructed after dehumping, using the spreader flap technique by folding the dorsal aspect of the upper lateral cartilages and suture it to the dorsal septal cartilage.

Appearance of the nose before and after the operation subjectively was evaluated using the visual analog scale(VAS).

Preoperative and postoperative obstructive symptoms were evaluated and compared using the nasal obstruction symptom evaluation (NOSE) scale.

These eleven patients (mean age=27.5) were followed for 4 months.

Cosmetic evaluation revealed the mean patient preoperative VAS score was (5.3) and the postoperative VAS score was (12.6.).

The preoperative NOSE score was(12.2) and the postoperative NOSE score was (7.7).

In 9 patients, who underwent the spreader flap, there was a significant subjective improvement aesthetically but not functionally, while two of the patients have had too narrow vault with severe obstructed symptoms and they were arranged for a revision rhinoplasty by spreader graft technique.

In conclusion we found that the use of spreader flap technique is effective both aesthetically but not functionally in most of our patients, and it avoids harvesting cartilage as in spreader graft technique.