Facial Plast Surg 2016; 32(06): 638-645
DOI: 10.1055/s-0036-1597144
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Rebuilding the Middle Vault in Rhinoplasty: A New Classification of Spreader Flaps/Grafts

Fazil Apaydin
1   Department of Otorhinolaryngology, Ege University Medical Faculty, Bornova, İzmir, Turkey
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Publikationsverlauf

Publikationsdatum:
29. Dezember 2016 (online)

Abstract

After hump removal in reduction rhinoplasty, one of the main steps is to rebuild the middle vault. Spreader grafts have long been the main tool for the surgeon. Within the last two decades, the spreader flaps have started to be very popular as well. In accordance with the experience and technical preferences of the surgeon, there are many different options. In this article, the spreader grafts are classified as traditional, modified, splinting, and reconstructive. The spreader flaps are designed in accordance with their relationship with the septum and the spreader grafts.

 
  • References

  • 1 Lang J. Clinical Anatomy of the Nose, Nasal Cavity and Paranasal Sinuses, 1st ed. Stuttgart: Georg Thieme Verlag; 1989
  • 2 Daniel RK, Letourneau A. Rhinoplasty: nasal anatomy. Ann Plast Surg 1988; 20 (1) 5-13
  • 3 Joseph J. Nasenplastik und sonstige Gesichtsplastik nebst einem Anhang über Mammaplastik. Leipzig: Verlag Curt Kabitzsch; 1931
  • 4 Sheen JH. Spreader graft: a method of reconstructing the roof of the middle nasal vault following rhinoplasty. Plast Reconstr Surg 1984; 73 (2) 230-239
  • 5 Constantian MB, Clardy RB. The relative importance of septal and nasal valvular surgery in correcting airway obstruction in primary and secondary rhinoplasty. Plast Reconstr Surg 1996; 98 (1) 38-54 , discussion 55–58
  • 6 Seyhan A. Method for middle vault reconstruction in primary rhinoplasty: upper lateral cartilage bending. Plast Reconstr Surg 1997; 100 (7) 1941-1943
  • 7 Oneal RM, Berkowitz RL. Upper lateral cartilage spreader flaps in rhinoplasty. Aesthet Surg J 1998; 18 (5) 370-371
  • 8 Toriumi DM. Management of the middle nasal vault. Operat Tech Plast Reconstr Surg 1995; 2: 16-30
  • 9 Apaydin F. Segmental reconstruction for nasal septal deviation. Facial Plast Surg 2013; 29 (6) 455-463
  • 10 Rohrich RJ, Hollier LH. Use of spreader grafts in the external approach to rhinoplasty. Clin Plast Surg 1996; 23 (2) 255-262
  • 11 Byrd HS, Salomon J, Flood J. Correction of the crooked nose. Plast Reconstr Surg 1998; 102 (6) 2148-2157
  • 12 Cerkes N. The crooked nose: principles of treatment. Aesthet Surg J 2011; 31 (2) 241-257
  • 13 Sazgar AA. The bony cartilaginous unit: the missing graft in septorhinoplasty. Int J Oral Maxillofac Surg 2016; 45 (8) 1006-1008
  • 14 Apaydin F. Septal surgery challenges in rhinoplasty. Facial Plast Surg 2016; 32 (4) 351-360
  • 15 Apaydin F. Bone recycling in nasal septal reconstruction. Facial Plast Surg 2013; 29 (6) 473-478
  • 16 Toriumi DM. Subtotal septal reconstruction: an update. Facial Plast Surg 2013; 29 (6) 492-501
  • 17 André RF, Vuyk HD. Reconstruction of dorsal and/or caudal nasal septum deformities with septal battens or by septal replacement: an overview and comparison of techniques. Laryngoscope 2006; 116 (9) 1668-1673
  • 18 Fomon S, Gilbert JG, Caron AL, Segal S. Collapsed ala: pathologic physiology and management. Arch Otolaryngol 1950; 51: 465-484
  • 19 Wurm J, Kovacevic M. A new classification of spreader flap techniques. Facial Plast Surg 2013; 29 (6) 506-514
  • 20 Ishida J, Ishida LC, Ishida LH, Vieira JC, Ferreira MC. Treatment of the nasal hump with preservation of the cartilaginous framework. Plast Reconstr Surg 1999; 103 (6) 1729-1733 , discussion 1734–1735
  • 21 Ashrafi AT. Management of upper lateral cartilages (ULCs) in rhinoplasty. World J Plast Surg 2014; 3 (2) 129-137
  • 22 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 (5) 346-353
  • 23 Gruber RP, Park E, Newman J, Berkowitz L, Oneal R. The spreader flap in primary rhinoplasty. Plast Reconstr Surg 2007; 119 (6) 1903-1910
  • 24 Byrd HS, Meade RA, Gonyon Jr DL. Using the autospreader flap in primary rhinoplasty. Plast Reconstr Surg 2007; 119 (6) 1897-1902
  • 25 Saedi B, Amali A, Gharavis V, Yekta BG, Most SP. Spreader flaps do not change early functional outcomes in reduction rhinoplasty: a randomized control trial. Am J Rhinol Allergy 2014; 28 (1) 70-74
  • 26 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 (6) 899-914
  • 27 Gwanmesia I, Couto R, Papay F. A cadaveric study comparing the efficacy of the Sheen spreader graft and the fulcrum spreader graft: part 1. Plast Reconstr Surg 2015; 136 (4) 669-676
  • 28 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 (4) 374-383