title: Anterior spreader flap technique: A new minimally invasive method for stabilising and widening the nasal valve.
abstract: BACKGROUND
  The 'anterior spreader flap' is a new minimally invasive technique, for the treatment of nasal valve insufficiency or stenosis. The aim of this study was to present our experience with a series of patients with nasal valve dysfunction corrected by the minimally invasive spreader flap technique.
  
  
  METHODS
  We performed a retrospective review of our patients with nasal valve malfunction who underwent the anterior spreader flap between June 2010 and June 2013. The patients had to judge their symptoms of nasal obstruction pre- and 12 months post-operatively by the Nasal Obstruction and Septoplasty Effectiveness (NOSE) quality-of-life assessment scale. The difference between the pre- and post-operative evaluations of each group and between the groups was calculated, and it was statistically analysed.
  
  
  RESULTS
  Forty-three patients were treated. In seven patients, the anterior spreader flap was performed as a single procedure (group F), in 15 patients the anterior spreader flap was combined with a septoplasty and a turbinoplasty (group FST), in 10 patients with a turbinoplasty (group FT) and in 11 with a septoplasty (group FS). All patients reported significant post-operative improvement in nasal breathing (p < 0.05). The mean improvement (diffNOSE) of all patients was 54.2 points. The 'FS' group and the 'FST' group showed best post-operative results, but there were no significant differences between the groups (p > 0.8).
  
  
  CONCLUSIONS
  The anterior spreader flap is an effective and safe method for minimally invasive improvement of nasal breathing in patients with nasal valve dysfunction.
authors.affiliation: Clinic for Facial Plastic Surgery, Beethovenstrasse 5, 8002 Zurich, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Bessler
authors.affiliation: Clinic for Hand-, Plastic- and Reconstructive Surgery, Cantonal Hospital, 5000 Aarau, Switzerland.
authors.forename: H
authors.initials: H
authors.lastname: Kim Haemmig
authors.affiliation: Neuroradiology, Medizinisch Radiologisches Institut MRI, Bahnhofplatz 3, 8001 Zurich, Switzerland.
authors.forename: B
authors.initials: B
authors.lastname: Schuknecht
authors.affiliation: Clinic for Hand-, Plastic- and Reconstructive Surgery, Cantonal Hospital, 5000 Aarau, Switzerland.
authors.forename: C
authors.initials: C
authors.lastname: Meuli-Simmen
authors.affiliation: Clinic for Hand-, Plastic- and Reconstructive Surgery, Cantonal Hospital, 5000 Aarau, Switzerland. Electronic address: benistrub@gmx.ch.
authors.forename: B
authors.initials: B
authors.lastname: Strub
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D015508:Nasal Obstruction / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D013536:Suture Techniques; D016896:Treatment Outcome
keywords: Anterior spreader flap; Nasal valve; Nasal valve dysfunction; Spreader flap