Facial Plast Surg
DOI: 10.1055/a-2302-9556
Original Research

Apaydin Classification of Spreader Flaps Updated

Marta Capelleras
1   Department of Otolaryngology Head & Neck Surgery, Ege University, Izmir, Turkiye
,
Meshari Saghir
2   Department of Otorhinolaryngology Head & Neck Surgery, Al Mutawa Medical Tower, Kuwait, Kuwait
,
Fazil Apaydin
3   Division of Facial Plastic and Reconstructive Surgery, Department of Otorhinolaryngology, Ege University Medical Faculty, Izmir, Turkiye
› Author Affiliations

Abstract

The use of spreader flaps (SFs) is very helpful in middle vault reconstruction. The aim of the study was to evaluate the versatility of Apaydin classification of SFs on a patient population. This was a retrospective analysis which included 120 rhinoplasty cases. Thorough preoperative planning adhering to precision profileplasty principles was conducted for all patients. The study employed six primary variants of SFs. SFs' types were utilized as follows: type 1 in 41 patients (34.2%), type 2 in 2 patients (1.7%), type 3A in 38 patients (31.7%), types 3B and 3D in 10 cases each (8.3%), type 3C in 2 cases (1.7%), type 4 in 5 cases (4.2%), type 5 in 7 cases (5.8%), and type 6 in 5 cases (4.2%). This study highlights that different SF techniques should be tailored according to the need of the patient when dealing with middle vault reconstruction during reduction rhinoplasty.



Publication History

Accepted Manuscript online:
10 April 2024

Article published online:
11 May 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Sheen JH. Spreader graft: a method of reconstructing the roof of the middle nasal vault following rhinoplasty. Plast Reconstr Surg 1984; 73 (02) 230-239
  • 2 Seyhan A. Method for middle vault reconstruction in primary rhinoplasty: upper lateral cartilage bending. Plast Reconstr Surg 1997; 100 (07) 1941-1943
  • 3 Oneal RM, Berkowitz RL. Upper lateral cartilage spreader flaps in rhinoplasty. Aesthet Surg J 1998; 18 (05) 370-371
  • 4 Gruber RP, Park E, Newman J, Berkowitz L, Oneal R. The spreader flap in primary rhinoplasty. Plast Reconstr Surg 2007; 119 (06) 1903-1910
  • 5 Wurm J, Kovacevic M. A new classification of spreader flap techniques. Facial Plast Surg 2013; 29 (06) 506-514
  • 6 Apaydin F. Rebuilding the middle vault in rhinoplasty: a new classification of spreader flaps/grafts. Facial Plast Surg 2016; 32 (06) 638-645
  • 7 Fomon S, Gilbert JG, Caron AL, Segal S. Collapsed Ala: Pathologic physiology and management. Arch Otolaryngol 1950; 51: 465-484
  • 8 Cerkes N. Concurrent elevation of the upper lateral cartilage perichondrium and nasal bone periosteum for management of dorsum: the perichondro-periosteal flap. Aesthet Surg J 2013; 33 (06) 899-914
  • 9 Apaydin F, Akyildiz S, Hecht DA, Toriumi DM. Rhinobase: a comprehensive database, facial analysis, and picture-archiving software for rhinoplasty. Arch Facial Plast Surg 2009; 11 (03) 209-211
  • 10 Ashrafi AT. Management of upper lateral cartilages (ULCs) in rhinoplasty. World J Plast Surg 2014; 3 (02) 129-137
  • 11 Kosins AM. Expanding indications for dorsal preservation rhinoplasty with cartilage conversion techniques. Aesthet Surg J 2021; 41 (02) 174-184
  • 12 Afrooz PN, Rohrich RJ. The Keystone: consistency in restoring the aesthetic dorsum in rhinoplasty. Plast Reconstr Surg 2018; 141 (02) 355-363
  • 13 Cottle MH, Loring RM, Fischer GG, Gaynon IE. The maxilla-premaxilla approach to extensive nasal septum surgery. AMA Arch Otolaryngol 1958; 68 (03) 301-313
  • 14 Robotti E, Choc IS, Jaber O. Use of the “Septal T” as a spacer and conformer for a properly contoured nasal tip in rhinoplasty. Aesthet Surg J 2017; 37 (01) 122-127
  • 15 Ferreira MG, Toriumi DM, Stubenitsky B, Kosins AM. Advanced preservation rhinoplasty in the era of osteoplasty and chondroplasty: how have we moved beyond the Cottle Technique?. Aesthet Surg J 2023; 43 (12) 1441-1453
  • 16 Sella GCP, Ferraz MBJ, Keim F. Use of electrosurgery to refine cartilaginous structures in rhinoplasty. Plast Surg Mod Tech. 2022; 6: 165
  • 17 Cerkes N. The crooked nose: principles of treatment. Aesthet Surg J 2011; 31 (02) 241-257
  • 18 Kovacevic M, Riedel F, Göksel A, Wurm J. Options for middle vault and dorsum restoration after hump removal in primary rhinoplasty. Facial Plast Surg 2016; 32 (04) 374-383
  • 19 Bitik O, Kamburoglu HO, Uzun H. The composite spreader flap. Aesthet Surg J 2019; 39 (02) 137-147
  • 20 Byrd HS, Meade RA, Gonyon Jr DL. Using the autospreader flap in primary rhinoplasty. Plast Reconstr Surg 2007; 119 (06) 1897-1902
  • 21 Yoo S, Most SP. Nasal airway preservation using the autospreader technique: analysis of outcomes using a disease-specific quality-of-life instrument. Arch Facial Plast Surg 2011; 13 (04) 231-233