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Outcome of Rhinoplasty in Patients Undergoing Autospreader Flaps Without Notable Dorsal Hump Reduction: A Clinical Trial Publisher Pubmed



Sazgar AA1, 4 ; Razmara N2 ; Razfar A3 ; Sazgar AK1 ; Amali A1
Authors
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Authors Affiliations
  1. 1. Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Otolaryngology, Head and Neck Surgery, Mashhad University of Medical Sciences, Imam Reza Hospital, Mashhad, Iran
  3. 3. Department of Head and Neck Surgery, University of California. Los Angeles Medical Center, Los Angeles, CA, United States
  4. 4. Department of Otolaryngology, Head and Neck Surgery, Vali-Asr Hospital, Imam Khomeini Medical Complex, Tehran University of Medical Sciences, Dr. Gharib Avenue, Keshavarz, Boulevard, Tehran, Iran

Source: Journal of Plastic# Reconstructive and Aesthetic Surgery Published:2019


Abstract

Background: Reconstruction of the nasal midvault is an important component of successful rhinoplasty outcomes. Use of the autospreader flap is a beneficial technique for preserving the middle vault. In the present study, we evaluated the esthetic and functional outcomes of this technique in patients without notable dorsal hump reduction. Methodology: A nonrandomized clinical trial was performed from December 2017 to April 2018 with a minimum follow-up time of 6 months. From among patients seeking rhinoplasty, 38 were eligible for inclusion in the study. The autospreader flap was used to recreate the middle vault in patients undergoing open rhinoplasty, with up to 2 mm bony and cartilaginous dorsal hump removal. Preoperative and postoperative standard photographs were obtained. Assessment of patients was based on Rhinoplasty Outcome Evaluation (ROE) and Nasal Obstruction Symptom Evaluation Scale (NOSE) scores. Objective assessment included quantitative analysis of anthropometric angles, mean dorsal width, nasal length, and projection which was performed on standard pre- and postoperative photos. Results: Overall, the patients had statistically significant improvement in their postoperative NOSE scores (9 vs. 6.92, p = 0.0001). The majority of patients were satisfied with the postoperative appearance of their noses. The mean nasal dorsal width (NDW) decreased postoperatively (43% vs. 36%). No difference was found between the mean height of the nose and projection pre- and postoperatively. There was a significant postoperative increase in the nasolabial angle and reduction in nasal length. Conclusions: The autospreader flap is an effective technique for preservation and restoration of the middle vault and dorsal esthetic line in cases of less than 2 mm dorsal hump reduction. Nasal function can be improved while achieving good cosmetic outcomes © 2019 Elsevier Ltd
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