title: Modified autospreader flap for nasal valve support: utilizing the spring effect of the upper lateral cartilage.
abstract: Nasal valve dysfunction has a role in up to 13% of adults complaining of chronic nasal obstruction yet it is overlooked by many physicians. In rhinoplasty and other nasal surgeries, preserving nasal function is the most significant issue. The autospreader flap has proved to be an effective spreader graft alternative. Adding the spring effect proposed in this study to the autospreader flap increases the width of the internal nasal valve, thus gaining two factors supporting the internal nasal valve. The modified autospreader flap technique is described in detail. Patients in this study were classified into two groups. The first group had no obstructive complaints and the second group had nasal obstructive complaints. Quantitative analysis of NOSE scale scores, endoscopic evaluation, and tomographic evaluation before and after the surgery were performed using statistical analysis. Survey responses were received from 22 patients. Significant improvement in the nasal valve angle width was found in both groups by the endoscopic and tomographic evaluation. Subjective evaluation using NOSE scale scores showed improvement in both groups. The greatest advantage of this technique is that it adds to the autospreader flap a spring action that widens the valve area. We found this technique to be reliable and simple to be performed with fairly good results and patient satisfaction. Level of evidence V Evidence from systematic reviews of descriptive and qualitative studies.
authors.affiliation: Department of Otorhinolaryngology, Alexandria Faculty of Medicine, Alexandria, Egypt, wael.khamis@alexmed.edu.eg.
authors.forename: Wael Khamis
authors.initials: WK
authors.lastname: Hussein
authors.forename: Samy
authors.initials: S
authors.lastname: Elwany
authors.forename: Motaz
authors.initials: M
authors.lastname: Montaser
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D017558:Elective Surgical Procedures; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055171:Nasal Cartilages / Q000637:transplantation*; D015508:Nasal Obstruction / Q000000981:diagnostic imaging / Q000601:surgery*; D017060:Patient Satisfaction; D011446:Prospective Studies; D012225:Rhinoplasty / Q000379:methods*; D013536:Suture Techniques / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed; D055815:Young Adult