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Facial Plast Surg 2013; 29(02): 140-146
DOI: 10.1055/s-0033-1341583
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Lateral Crural Underlay Spring Graft

Ferdinand C.A. Timmer
1   Department of Otolaryngology Head and Neck Surgery, Center for Facial Plastic Reconstructive Surgery, Diakonessenhuis, Utrecht/Zeist, The Netherlands
,
Jason A. Roth
1   Department of Otolaryngology Head and Neck Surgery, Center for Facial Plastic Reconstructive Surgery, Diakonessenhuis, Utrecht/Zeist, The Netherlands
,
Pontus K.E. Börjesson
1   Department of Otolaryngology Head and Neck Surgery, Center for Facial Plastic Reconstructive Surgery, Diakonessenhuis, Utrecht/Zeist, The Netherlands
,
Peter J.F.M. Lohuis
1   Department of Otolaryngology Head and Neck Surgery, Center for Facial Plastic Reconstructive Surgery, Diakonessenhuis, Utrecht/Zeist, The Netherlands
2   Department of Head & Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni van Leeuvenhoek Hospital, Amsterdam, The Netherlands
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Publikationsverlauf

Publikationsdatum:
05. April 2013 (online)

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Abstract

The objective of this study is to evaluate the functional and aesthetic results obtained from the use of the lateral crural underlay spring (LCUS) graft for the treatment of internal and external nasal valve collapse. In this retrospective study, preoperative and postoperative functional and aesthetic results were compared in patients undergoing treatment for internal or external nasal valve collapse. Results were scored by means of a questionnaire and visual analog scale completed by the patients. Eight patients were recruited and included in this study: 6 (75%) had an improvement in their functional scores, 1 (12%) remained unchanged, and 1 (12%) scored worse. The mean difference in functional scores after the intervention was 9.4 points (p < 0.005). There was no significant difference in aesthetic scores. We found evidence that the LCUS graft is effective for relieving nasal obstruction in patients with internal, external, or combined nasal valve collapse. The amount of increased sidewall tension and rigidity as well as the increase in nasal valve angle and cross-sectional area are determined by the length of the graft, which can be varied according to need.

Keywords

nasal valve collapse - alar batten - nasal valve surgery - lateral crural underlay graft - lateral crural underlay spring graft - rhinoplasty
 

  • References

  • 1 Haight JS, Cole P. The site and function of the nasal valve. Laryngoscope 1983; 93: 49-55
    PubMedGoogle Scholar
  • 2 Kern EB, Wang TD. Nasal valve surgery. In: Daniel RK, , ed. Aesthetic Plastic Surgery: Rhinoplasty. Boston, MA: Little, Brown; 1993: 613-630
    Google Scholar
  • 3 Elwany S, Thabet H. Obstruction of the nasal valve. J Laryngol Otol 1996; 110: 221-224
    CrossrefPubMedGoogle Scholar
  • 4 Toriumi DM, Josen J, Weinberger M, Tardy Jr ME. Use of alar batten grafts for correction of nasal valve collapse. Arch Otolaryngol Head Neck Surg 1997; 123: 802-808
    CrossrefPubMedGoogle Scholar
  • 5 Bloching MB. Disorders of the nasal valve area. GMS Curr Top Otorhinolaryngol Head Neck Surg 2007; 6: Doc07
    PubMedGoogle Scholar
  • 6 Gunter JP, Friedman RM. Lateral crural strut graft: technique and clinical applications in rhinoplasty. Plast Reconstr Surg 1997; 99: 943-952 , discussion 953–955
    CrossrefPubMedGoogle Scholar
  • 7 Alsarraf R, Larrabee Jr WF. Outcomes research in facial plastic surgery. Arch Facial Plast Surg 2001; 3: 7
    PubMedGoogle Scholar
  • 8 Stewart MG, Smith TL, Weaver EM , et al. Outcomes after nasal septoplasty: results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) study. Otolaryngol Head Neck Surg 2004; 130: 283-290
    CrossrefPubMedGoogle Scholar
  • 9 Lohuis PJ, Faraj-Hakim S, Knobbe A, Duivesteijn W, Bran GM. Split hump technique for reduction of the overprojected nasal dorsum: a statistical analysis on subjective body image in relation to nasal appearance and nasal patency in 97 patients undergoing aesthetic rhinoplasty. Arch Facial Plast Surg 2012; 14: 346-353
    CrossrefPubMedGoogle Scholar
  • 10 Likert R. A technique for the measurement of attitudes. Arch Psychol 1932; 140: 1-55
    PubMedGoogle Scholar
  • 11 Sheen JH. Spreader graft: a method of reconstructing the roof of the middle nasal vault following rhinoplasty. Plast Reconstr Surg 1984; 73: 230-239
    CrossrefPubMedGoogle Scholar
  • 12 Paniello RC. Nasal valve suspension. An effective treatment for nasal valve collapse. Arch Otolaryngol Head Neck Surg 1996; 122: 1342-1346
    CrossrefPubMedGoogle Scholar
  • 13 Park SS. The flaring suture to augment the repair of the dysfunctional nasal valve. Plast Reconstr Surg 1998; 101: 1120-1122
    CrossrefPubMedGoogle Scholar
  • 14 Lee DS, Glasgold AI. Correction of nasal valve stenosis with lateral suture suspension. Arch Facial Plast Surg 2001; 3: 237-240
    CrossrefPubMedGoogle Scholar
  • 15 Nuara MJ, Mobley SR. Nasal valve suspension revisited. Laryngoscope 2007; 117: 2100-2106
    CrossrefPubMedGoogle Scholar
  • 16 Boahene KD, Hilger PA. Alar rim grafting in rhinoplasty: indications, technique, and outcomes. Arch Facial Plast Surg 2009; 11: 285-289
    CrossrefPubMedGoogle Scholar
  • 17 Chait LA, Fayman MS. Treatment of postreconstructive collapsed nasal ala with a costal cartilage graft. Plast Reconstr Surg 1988; 82: 527-530
    PubMedGoogle Scholar
  • 18 Clark JM, Cook TA. The “butterfly” graft in functional secondary rhinoplasty. Laryngoscope 2002; 112: 1917-1925
    CrossrefPubMedGoogle Scholar
  • 19 Guyuron B, Michelow BJ, Englebardt C. Upper lateral splay graft. Plast Reconstr Surg 1998; 102: 2169-2177
    CrossrefPubMedGoogle Scholar
  • 20 Pedroza F, Anjos GC, Patrocinio LG, Barreto JM, Cortes J, Quessep SH. Seagull wing graft: a technique for the replacement of lower lateral cartilages. Arch Facial Plast Surg 2006; 8: 396-403
    CrossrefPubMedGoogle Scholar
  • 21 André RF, D'Souza AR, Kunst HP, Vuyk HD. Sub-alar batten grafts as treatment for nasal valve incompetence; description of technique and functional evaluation. Rhinology 2006; 44: 118-122
    PubMedGoogle Scholar
  • 22 Tellioglu AT, Cimen K. Turn-in folding of the cephalic portion of the lateral crus to support the alar rim in rhinoplasty. Aesthetic Plast Surg 2007; 31: 306-310
    CrossrefPubMedGoogle Scholar
  • 23 Sen C, Iscen D. Use of the spring graft for prevention of midvault complications in rhinoplasty. Plast Reconstr Surg 2007; 119: 332-336
    CrossrefPubMedGoogle Scholar
  • 24 Schlosser RJ, Park SS. Functional nasal surgery. Otolaryngol Clin North Am 1999; 32: 37-51
    CrossrefPubMedGoogle Scholar
  • 25 Yaniv E, Hadar T, Shvero J, Raveh E. Objective and subjective nasal airflow. Am J Otolaryngol 1997; 18: 29-32
    CrossrefPubMedGoogle Scholar
  • 26 Naito K, Cole P, Chaban R, Oprysk D. Nasal resistance, sensation of obstruction, and rhinoscopic findings compared. Am J Rhinol 1988; 2: 65-69
    CrossrefPubMedGoogle Scholar
  • 27 Hardcastle PF, White A, Prescott RJ. Clinical or rhinometric assessment of the nasal airway—which is better?. Clin Otolaryngol Allied Sci 1988; 13: 381-385
    PubMedGoogle Scholar
  • 28 Tardy ME, Garner ET. Inspiratory nasal obstruction secondary to alar and nasal valve collapse: technique for repair using autogenous cartilage. Operative Techniques in Otolaryngology–Head and Neck Surgery 1990; 1: 215-217
    PubMedGoogle Scholar
  • 29 Tardy ME. Rhinoplasty: The Art and the Science. Vol. II. Sculpture of the Nasal Tip. Philadelphia, PA: Saunders; 1996
    Google Scholar
  • 30 Pedroza F, Anjos GC, Patrocinio LG, Barreto JM, Cortes J, Quessep SH. Seagull wing graft: a technique for the replacement of lower lateral cartilages. Arch Facial Plast Surg 2006; 8: 396-403
    CrossrefPubMedGoogle Scholar
  • 31 Ghidini A, Dallari S, Marchioni D. Surgery of the nasal columella in external valve collapse. Ann Otol Rhinol Laryngol 2002; 111: 701-703
    CrossrefPubMedGoogle Scholar