The External Strip and Internal Spreader Graft Combined with Dorsal Preservation Rhinoplasty

Area of Science:

• Plastic Surgery
• Otolaryngology
• Facial Plastic Surgery

Background:

• Dorsal hump deformities and septal deviations are common issues in rhinoplasty.
• Traditional rhinoplasty methods often involve hump resection, but dorsal preservation techniques are increasingly favored.
• Spreader grafts and flaps are crucial for correcting deformities like open roof, deviations, and dorsal aesthetic lines.

Purpose of the Study:

• To demonstrate the effectiveness of combining external strip and internal spreader grafts with dorsal preservation rhinoplasty.
• To evaluate the cosmetic and functional outcomes of this combined surgical approach.

Main Methods:

• A retrospective analysis of 152 patients undergoing dorsal preservation rhinoplasty for nasal hump deformity (with or without septal deviation) between July 2019 and September 2022.
• External strip and internal spreader grafts were utilized in 52 patients.
• Inclusion criteria focused on specific nasal deformities, including C-shaped septal deviation and upper lateral cartilage (ULC) and anterior septal angle (W-ASA) segment concavity.
• Patient outcomes were assessed using the Rhinoplasty Outcome Evaluation (ROE) questionnaire preoperatively and at 12 months postoperatively.

Main Results:

• The study included patients with a median age of 24.9 years, with follow-up ranging from 16 to 26 months.
• Rhinoplasty Outcome Evaluation (ROE) scores significantly improved from a median of 56.5 preoperatively to 92.5 postoperatively (p<0.001).
• Excellent patient satisfaction was reported in 90% of cases, with grafts effectively addressing deviations and concavities without compromising the nasal dorsum.

Conclusions:

• Combining external strip and internal spreader grafts with dorsal preservation rhinoplasty offers an effective solution for dorsal hump and septal deviation deformities.
• This technique improves upper lateral cartilage (ULC) concavity, prevents anterior septal angle (W-ASA) segment collapse, and addresses nasal valve collapse.
• The approach leads to superior cosmetic and functional results, representing an advanced method in rhinoplasty.