AAFPRS089 - Spreader Grafts and Autospreaders in Rhinoplasty: A Systematic Review and Meta-analysis
Thursday, April 28, 2022
11:35 AM – 11:40 AM CT
Location: Landmark D
Cibele Madsen Buba MD; Priyesh N. Patel MD; Mikhail Saltychev MD PhD; Cherian K. Kandathil MD; Sam P. Most MD.
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California. (Madsen Buba)
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee. (Patel)
Department of Physical and Rehabilitation Medicine, Turku University Hospital and University of Turku, Turku, Finland. (Saltychev)
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California. (Kandathil and Most)
Clinical Research Fellow Stanford Otolaryngology- Head and Neck Surgery Stanford University Stanford, California
Background: Reduction of a dorsal hump alters the structure of the nose with resulting aesthetic and functional implications. Since resection of the dorsal hump consists of the removal of an important portion of the osseocartilaginous dorsum, preservation, or reconstruction of the middle third of the nose is imperative to prevent midvault insufficiency, nasal valve dysfunction and/or an inverted-V deformity. Both spreader graft and autospreader have been largely studied and used throughout the years. However, there is heterogeneity in the reported efficacy, in the outcome measures, and limited comparative data.
Learning objectives: To understand the importance and the difference between both grafts in reconstructing the mid vault.
Study Objective: To evaluate the evidence of surgical outcomes and complications of spreader graft and autospreader for mid vault reconstruction in a dorsal hump reduction.
Design Type: Systematic Review and Meta-analysis.
Method: The review protocol followed the Cochrane Handbook for Systematic Reviews of Interventions. Inclusion and exclusion criteria were based on the population, intervention, comparison, and outcome (PICO) framework.
Results: This study systematically evaluated outcomes and complications in 52 studies that were included in the qualitative analysis. Meta-analysis included only 17 studies that reported both preoperative and postoperative NOSE scores.
Conclusion: Based on available data, change in NOSE scores after rhinoplasty were similar in procedures that used spreader graft only or autospreader only or none at all. Complications did not differ significantly between groups. To increase the reliability and level of evidence, surgical outcomes measures should be standardized, and improved study methodology is required.