Abstracto

A novel technique for spreader flap by folding dorsal hump in primary Rhinoplasty patients

Hassan Assiri

Background: The dorsal hump is a common nasal deformity that requires reduction and reconstruction of the midvault since different deformities may occur if no reconstruction is performed. We describe our novel modified spreader flap, which involves keeping the large cartilaginous septal T hump attached to the upper lateral cartilages to increase the thickness and length of the flap.

Methods: In a prospective study that included 21 patients who met the criteria, patients were followed up for one year after surgery, with an assessment of the dorsal projection, tip projection, axis deviation, dorsal width and internal nasal valve grade. The modified Cottle maneuver and Rhinoplasty Outcome Evaluation score was also performed and obtained, respectively.

Results: Our novel technique was performed in 20 patients (95.2%). In one additional patient, we added a regular auto-spreader flap on the contralateral side. One year postoperatively, the axis was found in the midline in all patients (100%). Assessment of internal valve collapse showed that collapse was reduced to grade 0 in 13 patients (61.9%) and grade 1 in 8 patients (38.1%). There were no hump recurrences or visible irregularities. The results showed a statistically significant difference between the pre- and postoperative values in dorsal projection, dorsal width and rhinoplasty outcome evaluation score.

Conclusion: This novel technique shows promising results that were statistically significant in reducing dorsal hump projection and width, correcting axis deviation and improving internal nasal valve and rhinoplasty outcome evaluation score, while being less cartilage- and time-consuming