title: A Cadaveric Study Comparing the Efficacy of the Sheen Spreader Graft and the Fulcrum Spreader Graft: Part 1.
abstract: BACKGROUND
  Middle vault collapse is one of the common causes of airway obstruction. Several techniques have been described to alleviate this problem. The Sheen spreader graft is a well-established technique. The fulcrum spreader graft has been in use at the authors' institution for 10 years. No studies currently exist that have compared the efficacy of middle vault reconstruction methods. In this first part of their studies, the authors have compared the efficacy of the Sheen spreader graft technique to the fulcrum spreader graft technique under normal atmospheric conditions.
  
  
  METHODS
  Twenty fresh unemblamed cadavers were used for the study. Outcome variables were cross-sectional area at three points within the nose, minimum cross-sectional area, resistance, volume, and minimum distance. Exposure variables were control, Sheen, and fulcrum. Data were acquired with the aid of an acoustic rhinometer.
  
  
  RESULTS
  Analysis of the data showed that the fulcrum spreader graft technique provided statistically significant outcomes compared with control and the Sheen technique.
  
  
  CONCLUSIONS
  The fulcrum spreader graft technique may be a more effective technique for middle vault reconstruction compared with the Sheen spreader graft technique.
authors.affiliation: Cleveland, Ohio From the Department of Plastic and Reconstructive Surgery, Cleveland Clinic Foundation.
authors.forename: Ivo
authors.initials: I
authors.lastname: Gwanmesia
authors.forename: Rafael
authors.initials: R
authors.lastname: Couto
authors.forename: Francis
authors.initials: F
authors.lastname: Papay
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055171:Nasal Cartilages / Q000637:transplantation*; D009300:Nasal Septum / Q000601:surgery*; D009666:Nose / Q000033:anatomy & histology / Q000601:surgery; D012225:Rhinoplasty / Q000379:methods*