Comparison of Unilateral versus Bilateral Spreader Grafts in Crooked Indian Noses

Although bilateral spreader grafts play a crucial role in rhinoplasty of crooked noses, adequacy of the cartilage often remains the key limiting factor, especially in Indian noses. Instead, a unilateral spreader graft can be used along with the neoseptum to ensure good functional and aesthetic outcomes. The present study compares the functional and aesthetic outcomes of unilateral vs. bilateral spreader grafts in patients with crooked noses.

It is a retrospective analysis of cases who underwent septorhinoplasty in a tertiary care referral hospital from March 2020 to February 2024. A total of 60 cases were included in the study, where unilateral and bilateral spreader grafts were used in 30 patients each. The functional and aesthetic outcomes were evaluated at the end of 6 and 12 months after the surgery.

There was significant improvement in the functional quality of life (VAS score, NOSE scores and angle at internal nasal valve) and aesthetic quality of life (ROE and FROI-17 scores) at 6 and 12 months after the surgery in each group (p < 0.01). There was a significant improvement in the internal nasal valve angle in each group (p < 0.01). We did not find any difference when functional and aesthetic outcomes were compared between the unilateral vs. bilateral group (p > 0.05). There was no significant difference in the intraoperative and postoperative complications when comparing the two groups.

Septorhinoplasty in crooked noses is always a challenge for any surgeon due to the recurrence of symptoms after the surgery. Both unilateral and bilateral spreader grafts can be successfully used in crooked Indian noses, ensuring good functional and aesthetic results without any significant complications. Though it is a small and heterogeneous sample, the results were quite encouraging until 12 months after the surgery.

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