Skip to main content
Log in

Modified autospreader flap for nasal valve support: utilizing the spring effect of the upper lateral cartilage

  • Miscellaneous
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

A Letter to the Editor to this article was published on 09 January 2015

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11

Similar content being viewed by others

References

  1. Helal MZ, El-Tarabishi M, Magdy Sabry S, Yassin A, Rabie A, Lin SJ (2010) Effects of rhinoplasty on the internal nasal valve: a comparison between internal continuous and external perforating osteotomy. Ann Plast Surg 64(5):649–657

    CAS  PubMed  Google Scholar 

  2. Schlosser RJ, Park SS (1999) Functional rhinoplasty. Operative techniques in otolaryngology. Head Neck Surg 10(3):203–208

    Google Scholar 

  3. Elwany S, Thabet H (1996) Obstruction of the nasal valve. J Laryngol Otol 110(3):221–224

    Article  CAS  PubMed  Google Scholar 

  4. Miman MC, Deliktas H, Ozturan O, Toplu Y, Akarcay M (2006) Internal nasal valve: revisited with objective facts. Otolaryngol Head Neck Surg 134(1):41–47

    Article  PubMed  Google Scholar 

  5. Roithmann R, Cole P, Chapnik J, Barreto SM, Szalai JP, Zamel N (1994) Acoustic rhinometry, rhinomanometry, and the sensation of nasal patency: a correlative study. J Otolaryngol 23(6):454–458

    CAS  PubMed  Google Scholar 

  6. Constantian MB, Clardy RB (1996) The relative importance of septal and nasal valvular surgery in correcting airway obstruction in primary and secondary rhinoplasty. Plast Reconstr Surg 98(1):38–54 (discussion 38–55)

    Article  CAS  PubMed  Google Scholar 

  7. Sheen JH (1984) Spreader graft: a method of reconstructing the roof of the middle nasal vault following rhinoplasty. Plast Reconstr Surg 73(2):230–239

    Article  CAS  PubMed  Google Scholar 

  8. Andre RF, Paun SH, Vuyk HD (2004) Endonasal spreader graft placement as treatment for internal nasal valve insufficiency: no need to divide the upper lateral cartilages from the septum. Arch Facial Plast Surg 6(1):36–40

    Article  PubMed  Google Scholar 

  9. Pepper JP, Baker SR (2011) The autospreader flap in reduction rhinoplasty. Arch Facial Plast Surg 13(3):172

    PubMed  Google Scholar 

  10. Yoo S, Most S (2011) Nasal airway preservation using the autospreader technique: analysis of outcomes using a disease-specific quality-of-life instrument. Arch Facial Plast Surg 13(4):231–233

    Article  PubMed  Google Scholar 

  11. Lipan MJ, Most SP (2013) Development of a severity classification system for subjective nasal obstruction. JAMA Facial Plastic Surg 15(5):358–361

    Article  Google Scholar 

  12. Stewart MG, Witsell DL, Smith TL, Weaver EM, Yueh B, Hannley MT (2004) Development and validation of the nasal obstruction symptom evaluation (NOSE) scale. Otolaryngol Head Neck Surg 130(2):157–163

    Article  PubMed  Google Scholar 

  13. Poetker DM, Rhee JS, Mocan BO, Michel MA (2004) Computed tomography technique for evaluation of the nasal valve. Arch Facial Plast Surg 6(4):240–243

    Article  PubMed  Google Scholar 

  14. Beriat K, Karadağ D (2010) The value of computed tomography in evaluation of internal nasal valve angle. Med J Trakya Univ 27(3):270–274

    Google Scholar 

Download references

Conflict of interest

All financial and material support for this research and work were provided by the Alexandria University Hospital. We do not have any financial interests with companies or other entities that have an interest in the information in the Contribution (e.g., grants, advisory boards, employment, consultancies, contracts, honoraria, royalties, expert testimony, partnerships, or stock ownership in medically‐related fields). Indication of no financial disclosures; all patients were performed in the university hospital as part of a routine management that all patients receive without the need of an extra material or financial support.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Wael Khamis Hussein.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hussein, W.K., Elwany, S. & Montaser, M. Modified autospreader flap for nasal valve support: utilizing the spring effect of the upper lateral cartilage. Eur Arch Otorhinolaryngol 272, 497–504 (2015). https://doi.org/10.1007/s00405-014-3309-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-014-3309-7

Keywords

Navigation