Quantitative Analysis of Functional Rhinoplasty Procedures: A Cadaveric Study to Evaluate a Novel Assessment Technique

Abstract

Objectives:

A wide array of surgical techniques has been developed to address internal nasal valve collapse. In particular, butterfly grafts and spreader grafts are used ubiquitously without any objective comparison being made on the efficacy of these approaches. The objective of this study was to quantitatively assess the effect that these techniques have on lateral nasal wall compliance.

Methods:

A total of 11 fresh nonfixed cadavers (22 valves) were utilized for this study. Baseline measurements of lateral wall compliance were performed using a tension gauge and a novel procedure (herein described), and each nasal valve was measured independently. The valves were augmented with butterfly graft, endonasal spreader graft, and open spreader graft. Lateral nasal wall compliance was measured after each technique, and statistical analysis was performed.

Results:

There was an increase in force required to displace the lateral nasal wall compared with baseline after butterfly and endonasal spreader techniques (P < .05). The greatest effect was after butterfly-type graft placement (P < .05). An endonasal spreader graft technique resulted in a stiffer lateral nasal wall when compared to the open technique (P < .05). Open spreader graft had no effect relative to baseline measurements.

Conclusions:

This cadaveric study describes the application of a novel assessment tool used to quantitatively compare different grafting techniques used in functional rhinoplasty. Butterfly grafts are the most effective in strengthening the lateral nasal wall. Endonasal spreader grafts are also effective to a lesser degree. Open spreader techniques had no effect on the compliance of the lateral nasal wall.