Comparison of Aesthetic and Functional Outcomes of Spreader Graft and Autospreader Flap in Rhinoplasty.

Background: Although the assignment and suturing of the spreader graft to the septum is a routine part of rhinoplasty, it is a time wasting procedure and some problems may occur. Rather, autospreader flap is a new method that the dorsal part of the upper lateral cartilage is used as its own graft. In the present study, we intended to compare the functional and aesthetic outcomes of these two techniques of rhinoplasty.

Methods: In a clinical trial, patients who referred to 15 Khordad Hospital for elective rhinoplasty during 2013-2014 were enrolled. The functional and aesthetic outcomes were compared between the two techniques of spreader graft and autospreader flap using rhinomanometry and satisfaction questionnaire in two stages before and one months after the surgery.

Results: Total nasal airway resistance increased significantly by both spreader graft and autospreader flap, but the difference between the two methods was not statistically significant. The total nasal flow before and after the surgery significantly decreased using both techniques, but this reduction was not significant between the two methods of surgery. When questioned about the satisfaction with the surgery outcomes, 18 subjects (36%) had complete aesthetic satisfaction, 25 (50%) were partial satisfied and 7 subjects (14%) were unsatisfied from aesthetic results. The rate of patient's satisfaction in both groups was higher for functional outcome. Overall, 32 (64%) subjects were completely satisfied, 13 (26%) were partially satisfied and 5 (10%) subjects did not report satisfaction. Loss of respiratory function in both groups was inevitable due to short time post-operative period.

Conclusion: Both spreader graft and autospreader flap techniques can be used in the preservation and restoration of the normal internal nasal valve angle, as well as restoration of dorsal aesthetic lines of the nasal dorsum.