The Effect of Spreader Graft Placement on the Functional and Aesthetic Results of the Surgery in Patients Undergoing Septorhinoplasty

Öz

Objective: It is aimed to compare the functional and aesthetic results of the surgery in patients who underwent septorhinoplasty with and without a spreader graft. Material and Methods: In the study, 52 patients who underwent septorhinoplasty between 2018 and 2022 were retrospectively analyzed. The patients were divided into two groups: those with spreader grafts (Group 1, n=30) and those without spreader grafts (Group 2, n=22). The functional and aesthetic results of the patients were evaluated with the nasal obstruction symptom rating scale (NOSE), the sinonasal outcome test-22 (SNOT-22) and the facial appearance satisfaction (FACE-Q) scale before the surgery and postoperatively. Results: There was no significant difference between the groups in terms of age and gender. Postoperative NOSE and SNOT-22 scores were significantly lower than preoperative scores in both groups (p<0.05). FACE-Q score, on the other hand, was significantly higher after surgery than preoperative scores (p<0.05). When the groups were compared with each other, postoperative NOSE and SNOT-22 scores were higher in the group without spreader (group 2). The postoperative FACE-Q score was higher in the spreader group (group 1). Conclusion: In our study, it was concluded that the functional and aesthetic results of septorhinoplasty surgery performed with a spreader graft were better than the surgery performed without a spreader graft, when evaluated with patient-based questionnaire studies.

Anahtar Kelimeler

• Nose
• rhinoplasty
• spreader graft

SEPTORİNOPLASTİ YAPILAN HASTALARDA SPREADER GREFT KONULMASININ AMELİYATIN FONKSİYONEL VE ESTETİK SONUÇLARI ÜZERİNE ETKİSİ

Öz

Amaç: Spreader greft konularak ve konulmadan septorinoplasti ameliyatı yapılan hastalarda, ameliyatın fonksiyonel ve estetik sonuçlarının karşılaştırılması amaçlanmıştır. Gereç ve Yöntemler: Çalışmada, 2018-2022 tarihleri arasında septorinoplasti ameliyatı yapılan 52 hasta retrospektif olarak incelendi. Hastalar spreader greft konulanlar (Grup 1, n=30) ve spreader greft konulmayanlar (Grup 2, n=22) olmak üzere iki gruba ayrıldı. Hastaların fonksiyonel ve estetik sonuçları ameliyat öncesi ve ameliyat sonrası burun tıkanıklığı semptom değerlendirme ölçeği (NOSE), sinonazal sonuç testi-22 (SNOT-22) ve yüz görünümünden memnuniyet (FACE-Q) ölçeği ile değerlendirildi. Bulgular: Gruplar arasında yaş ve cinsiyet açısından anlamlı bir farklılık saptanmadı. Her iki grupta da ameliyat sonrası NOSE ve SNOT-22 skorları, ameliyat öncesi skorlara kıyasla, anlamlı düzeyde düşük idi (p<0.05). FACE-Q skoru ise ameliyat sonrası skorları ameliyat öncesi skorlara göre anlamlı derecede yüksek idi (p<0.05). Gruplar birbirleri ile karşılaştırıldığında, postoperatif NOSE ve SNOT-22 skorları spreader konulmayan grubun (grup 2) daha yüksekti. Postoperatif FACE-Q skoru ise spreader konulan grubun (grup 1) daha yüksekti. Sonuç: Çalışmamızda, spreader greft konularak yapılan septorinoplasti ameliyatının hasta bazlı anket çalışmaları ile değerlendirildiğinde fonksiyonel ve estetik sonuçlarının spreader greft konulmadan yapılan ameliyata göre daha iyi olduğu sonucuna varıldı.

Anahtar Kelimeler

• Burun
• rinoplasti
• spreader greft

Kaynakça

1. Apaydin F. Nasal valve surgery. Facial Plast Surg. 2011;27(2):179-91.
2. Sheen JH. Spreader graft: a method of reconstructing the roof of the middle nasal vault following rhinoplasty. Plast Reconstr Surg. 1984;73(2):230-9.
3. Fuller JC, Levesque PA, Lindsay RW. Assessment of the EuroQol 5-dimension questionnaire for detection of clinically significant global health-related quality-of-life improvement following functional septorhinoplasty. JAMA Facial Plast Surg. 2017;19(2):95-100.
4. Klassen AF, Cano SJ, East CA, Baker SB, Badia L, Schwitzer JA et al. Development and Psychometric Evaluation of the FACE-Q Scales for Patients Undergoing Rhinoplasty. JAMA Facial Plast Surg. 2016;18(1):27-35.
5. Karahatay S, Taşlı H, Karakoç Ö, Aydın Ü, Türker T. Reliability and validity of the Turkish Nose Obstruction Symptom Evaluation (NOSE) scale. Turk J Med Sci. 2018;48(2):212-6.
6. Cakir Cetin A, Kumus O, Keskinoglu P, Sutay S, Ecevit MC. Turkish validation of the Sino-Nasal Outcome Test-22. Clin Otolaryngol. 2019;44(4):557-64.
7. Marakami C (2004) Nasal valve collapse. Ear Nose Throat J. 2004;83(3):163-4.
8. Pade J, Hummel T. Olfactory function following nasal surgery. Laryngoscope. 2008; 118(7):1260-4.

9. Ingels KJ, Orhan KS, van Heerbeek N. The effect of spreader grafts on nasal dorsal width in patients with nasal valve insufficiency. Arch Facial Plast Surg. 2008;10(5):354-6.
10. Faris C, Koury E, Kothari P, Frosh A. Functional rhinoplasty with batten and spreader grafts for correction of internal nasal valve incompetence. Rhinology. 2006;44(2):114-7.
11. Jang YJ, Sinha V. Spreader graft in septo-rhinoplasty. Indian J Otolaryngol Head Neck Surg. 2007;59(2):100-2.
12. Yankov D. Functional and aesthetic effects of spreader grafts technique in rhinoplasty. Scr Sci Medica 2014;46:68–73
13. Goffart Y, Karelle S, Daele J. Free spreader grafts in rhinoplasty. Eur J Plast Surg. 2015;38(5):355-62.
14. Fuller JC, Levesque PA, Lindsay RW. Analysis of Patient-Perceived Nasal Appearance Evaluations Following Functional Septorhinoplasty With Spreader Graft Placement. JAMA Facial Plast Surg. 2019;21(4):305-11.
15. de Pochat VD, Alonso N, Mendes RR, Cunha MS, Menezes JV. Nasal patency after open rhinoplasty with spreader grafts. J Plast Reconstr Aesthet Surg. 201;65(6):732-8.
16. Wagner W, Schraven SP. Spreader grafts in septorhinoplasty. Laryngorhinootologie. 2011;90 (5):264-74.
17. Gruber RP, Park E, Newman J, Berkowitz L, Oneal R. The spreader flap in primary rhinoplasty. Plast Reconstr Surg. 2007;119(6):1903-10.
18. Saedi B, Amali A, Gharavis V, Yekta BG, Most SP. Spreader flaps do not change early functional outcomes in reduction rhinoplasty: a randomized control trial. Am J Rhinol Allergy. 2014;28(1):70-4.
19. Hassanpour SE, Heidari A, Moosavizadeh SM, Tarahomi MR, Goljanian A, Tavakoli S. Comparison of aesthetic and functional outcomes of spreader graft and autospreader flap in rhinoplasty. World J Plast Surg. 2016;5(2):133-8.
20. Sowder JC, Thomas AJ, Gonzalez CD, Limaye NS, Ward PD. Use of spreader flaps without dorsal hump reduction and the effect on nasal function. JAMA Facial Plast Surg. 2017;19(4):287-92.
21. Hussein WK, Elwany S, Montaser M. Modified autospreader flap for nasal valve support: utilizing the spring effect of the upper lateral cartilage. Eur Arch Otorhinolaryngol. 2015;272(2):497-504.