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Introduction <p>The use of either an open or closed approach in rhinoplasty has been a topic of debate. Widening the narrow internal nasal valve area through internal nasal valve augmentation presents a strong case for an open approach. However, this study presents a direct method for fixing spreader grafts using a closed approach, which offers the benefits of precise placement and stability without an external scar.</p> Materials and methods <p>Nine patients with functional and/or cosmetic complaints that need spreader grafts insertion were enrolled in the study. Spreader grafts placed and fixed by stitches using a closed rhinoplasty approach with additional esthetic steps added as necessary.</p> Results <p>Valve collapse was secondary in 2 cases, and the spreader graft was inserted bilaterally in all but one patient. Their complaint was either functional (44%), cosmetic (22%), or both (33%). NOSE scores showed improvement in all patients with a mean operative time was (68.68 ± 12.45 SD) minutes and postoperative complications were acceptably low.</p> Conclusion <p>In this report, we describe fixation of spreader graft through a closed technique with visualization of the entire septal cartilage frame. This method combines the advantages of direct manipulation and fixation with all the benefits of a closed approach.</p>

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Spreader graft fixation through a closed rhinoplasty approach: descriptive study and preliminary clinical experience

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月23日

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  • Eman Hamdy,
  • Fedaey Habaza,
  • Hossam Elsisi

摘要

Introduction

The use of either an open or closed approach in rhinoplasty has been a topic of debate. Widening the narrow internal nasal valve area through internal nasal valve augmentation presents a strong case for an open approach. However, this study presents a direct method for fixing spreader grafts using a closed approach, which offers the benefits of precise placement and stability without an external scar.

Materials and methods

Nine patients with functional and/or cosmetic complaints that need spreader grafts insertion were enrolled in the study. Spreader grafts placed and fixed by stitches using a closed rhinoplasty approach with additional esthetic steps added as necessary.

Results

Valve collapse was secondary in 2 cases, and the spreader graft was inserted bilaterally in all but one patient. Their complaint was either functional (44%), cosmetic (22%), or both (33%). NOSE scores showed improvement in all patients with a mean operative time was (68.68 ± 12.45 SD) minutes and postoperative complications were acceptably low.

Conclusion

In this report, we describe fixation of spreader graft through a closed technique with visualization of the entire septal cartilage frame. This method combines the advantages of direct manipulation and fixation with all the benefits of a closed approach.