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Facial Plast Surg 2016; 32(01): 042-048
DOI: 10.1055/s-0035-1570326
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Conchal Cartilage Butterfly Graft

Oren Friedman
1   Department of Otorhinolaryngology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
,
Orly Coblens
1   Department of Otorhinolaryngology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
› Author Affiliations
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Publication History

Publication Date:
10 February 2016 (online)

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Abstract

Nasal obstruction due to weakening of the nasal sidewall is a very common patient complaint. The conchal cartilage butterfly graft is a proven technique for the correction of nasal valve collapse. It allows for excellent functional results, and with experience and attention to technical detail, it may also provide excellent cosmetic results. While this procedure is most useful for restoring form and function in cases of secondary rhinoplasty following the reduction of nasal support structures, we have found it to be a very powerful and satisfying technique in primary rhinoplasty as well. This article aims to describe the butterfly graft, discuss its history, and detail the technical considerations which we have found useful.

Keywords

rhinoplasty - functional rhinoplasty - nasal valve
 

  • References

  • 1 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
    CrossrefPubMedGoogle Scholar
  • 2 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
    CrossrefPubMedGoogle Scholar
  • 3 Clark JM, Cook TA. The ‘butterfly’ graft in functional secondary rhinoplasty. Laryngoscope 2002; 112 (11) 1917-1925
    CrossrefPubMedGoogle Scholar
  • 4 Stucker FJ, Hoasjoe DK. Nasal reconstruction with conchal cartilage. Correcting valve and lateral nasal collapse. Arch Otolaryngol Head Neck Surg 1994; 120 (6) 653-658
    CrossrefPubMedGoogle Scholar
  • 5 Friedman O, Cook TA. Conchal cartilage butterfly graft in primary functional rhinoplasty. Laryngoscope 2009; 119 (2) 255-262
    CrossrefPubMedGoogle Scholar
  • 6 Akcam T, Friedman O, Cook TA. The effect on snoring of structural nasal valve dilatation with a butterfly graft. Arch Otolaryngol Head Neck Surg 2004; 130 (11) 1313-1318
    CrossrefPubMedGoogle Scholar
  • 7 Chaiet SR, Marcus BC. Nasal tip volume analysis after butterfly graft. Ann Plast Surg 2014; 72 (1) 9-12
    CrossrefPubMedGoogle Scholar
  • 8 Wittkopf M, Wittkopf J, Ries WR. The diagnosis and treatment of nasal valve collapse. Curr Opin Otolaryngol Head Neck Surg 2008; 16 (1) 10-13
    CrossrefPubMedGoogle Scholar
  • 9 Kasperbauer JL, Kern EB. Nasal valve physiology. Implications in nasal surgery. Otolaryngol Clin North Am 1987; 20 (4) 699-719
    PubMedGoogle Scholar
  • 10 Stacey DH, Cook TA, Marcus BC. Correction of internal nasal valve stenosis: a single surgeon comparison of butterfly versus traditional spreader grafts. Ann Plast Surg 2009; 63 (3) 280-284
    CrossrefPubMedGoogle Scholar
  • 11 Schlosser RJ, Park SS. Functional nasal surgery. Otolaryngol Clin North Am 1999; 32 (1) 37-51
    CrossrefPubMedGoogle Scholar
  • 12 Ballert JA, Park SS. Functional rhinoplasty: treatment of the dysfunctional nasal sidewall. Facial Plast Surg 2006; 22 (1) 49-54
    Article in Thieme ConnectPubMedGoogle Scholar
  • 13 Hage J. Collapsed alae strengthened by conchal cartilage (the butterfly graft). Br J Plast Surg 1965; 18: 92-96
    CrossrefPubMedGoogle Scholar
  • 14 Bridger GP. Physiology of the nasal valve. Arch Otolaryngol 1970; 92 (6) 543-553
    CrossrefPubMedGoogle Scholar
  • 15 Haight JS, Cole P. The site and function of the nasal valve. Laryngoscope 1983; 93 (1) 49-55
    PubMedGoogle Scholar
  • 16 Stucker FJ, Lian T, Karen M. Management of the keel nose and associated valve collapse. Arch Otolaryngol Head Neck Surg 2002; 128 (7) 842-846
    CrossrefPubMedGoogle Scholar
  • 17 Rhee JS, Poetker DM, Smith TL, Bustillo A, Burzynski M, Davis RE. Nasal valve surgery improves disease-specific quality of life. Laryngoscope 2005; 115 (3) 437-440
    CrossrefPubMedGoogle Scholar
  • 18 André RF, Vuyk HD. The “butterfly graft” as a treatment for internal nasal valve incompetence. Plast Reconstr Surg 2008; 122 (2) 73e-74e
    CrossrefPubMedGoogle Scholar
  • 19 Mink PJ. Le nez Comme Voie Respiratory. Press Otolaryngol (Belg) 1903; 481-496
    PubMedGoogle Scholar
  • 20 Saleh AM, Younes A, Friedman O. Cosmetics and function: quality-of-life changes after rhinoplasty surgery. Laryngoscope 2012; 122 (2) 254-259
    CrossrefPubMedGoogle Scholar