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Related Experiment Video

Updated: Jul 15, 2026

Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation

Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation

Published on: June 20, 2018

The spreader flap in primary rhinoplasty.

Ronald P Gruber¹, Eddie Park, Jennifer Newman

¹Stanford, San Francisco, and Campbell, Calif.; and Ann Arbor, Mich. From Stanford University, the University of California, San Francisco, private practice, and the University of Michigan.

Plastic and Reconstructive Surgery

|April 19, 2007

Summary

This study introduces a spreader flap technique for rhinoplasty, using upper lateral cartilages to reconstruct the middle nasal third. This method avoids donor cartilage, simplifying reconstruction, especially in open rhinoplasty procedures.

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Area of Science:

Plastic Surgery
Otolaryngology
Nasal Reconstruction

Background:

Primary rhinoplasty often involves humpectomy, discarding upper lateral cartilage.
Middle nasal third reconstruction frequently requires spreader grafts.
An alternative is creating "spreader flaps" from existing upper lateral cartilages.

Purpose of the Study:

To evaluate the efficacy of a spreader flap technique for nasal reconstruction in rhinoplasty.
To compare the spreader flap technique with traditional spreader grafts.

Main Methods:

A tunnel is created on the underside of the upper lateral cartilage.
The cartilage is released and rolled into a flap, secured with sutures.
Scoring may be needed; the flap is attached to the dorsal septum.

Main Results:

Spreader flaps successfully reconstructed the middle nasal third in most patients (21 open, 4 closed approach).
The technique was easier in open vs. closed approaches.
Few patients required additional spreader grafts due to narrow flaps; one open approach patient had inadequate nasal width postoperatively.

Conclusions:

Spreader flaps offer an alternative to traditional spreader grafts, eliminating the need for donor cartilage.
The technique is easily performed in open rhinoplasty.
Long-term outcomes for the closed approach require further investigation.