The use of high-density porous polyethylene as a custom-made nasal spreader graft

The concept and technique of using high-density porous polyethylene (HDPP), a nonresorbable synthetic material, for nasal spreader grafts, are presented. This material is thought to be particularly useful in revision (secondary or tertiary) rhinoplasty, in which internal valve collapse frequently is confronted and septal cartilage often is unavailable because it has been harvested for spreader or other grafts. Sold as a thin plain sheet (0.85 x 38 x 50 mm) that can be cut to an appropriate size for spreader grafts, HDPP is a ready-to-use material commercially available on the market. Because HDPP permits ingrowths of fibrous tissue inside and around, it is a nonabsorbable material that stabilizes the upper lateral cartilages in their new position and maintains the appropriate internal valve angle. The authors used this material for 15 patients undergoing secondary (n = 12) and tertiary (n = 3) rhinoplasty because of valvular collapse. During the mean follow-up period of 16 months (range, 8-30 months), neither complication nor recurrence of airway obstruction occurred.