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Secondary Contouring for the Butterfly Graft: Improving Form and Preserving Function
Rahul Varman1, Jonas Miller2, J Madison Clark3
1Department of Otolaryngology-Head & Neck Surgery, Creighton University, Omaha, Nebraska, U.S.A.
The Laryngoscope
|September 28, 2024
Summary
Secondary butterfly graft (BFG) contouring improves nasal appearance and breathing for external irregularities. While most patients see benefits, a small risk of worsened breathing exists, emphasizing careful patient selection.
Area of Science:
- Plastic Surgery
- Rhinology
- Facial Reconstruction
Background:
- The butterfly graft (BFG) is used for nasal reconstruction.
- External nasal irregularities can occur after primary BFG surgery.
- Secondary contouring aims to correct these aesthetic and functional issues.
Purpose of the Study:
- To identify demographic factors associated with seeking secondary contouring after BFG.
- To evaluate patient-reported outcomes following secondary BFG contouring procedures.
- To assess the safety and efficacy of secondary BFG contouring.
Main Methods:
- Retrospective analysis of 374 patients undergoing primary BFG.
- Identified 10 patients who underwent secondary contouring.
- Collected data on demographics, Nasal Obstruction Symptoms Evaluation (NOSE) scores, Rhinosinusitis Disability Index (RSDI), and Decision Regret Scale (DRS).
Main Results:
- Secondary contouring rate was 2.7%; predominantly white females (90%).
- Significant improvement in NOSE scores post-primary surgery and maintained improvement post-secondary contouring.
- 40% reported worsening of NOSE scores after secondary contouring compared to after primary surgery; minimal regret reported.
Conclusions:
- Secondary BFG contouring is a viable option for external nasal complaints.
- It offers improvements in nasal appearance and breathing outcomes.
- Careful patient selection and counseling are crucial due to potential for slight worsening of breathing.
