Preservação da válvula nasal interna em rinoplastia primária – Enxertos expansores Versus Retalhos em mola

Abstract

Introduction: The procedures in rhinoplasty have gone through an evolutionary process in order to preserve respiratory function. Thus, reductional techniques have been replaced by structured approach. The spreaders grafts have become popular in an attempt to maintain internal nasal valve open through their expanding effect, but has shown greater potential morbidity to the septum by the amount of removed cartilage. Recently, the spring flaps emerged as an alternative technique, using the upper lateral cartilage for reconstruction. This study aims to compare the respiratory function in primary rhinoplasty using as surgical technique the spreader graft or spring flap. Method: Prospective, longitudinal, observational. We studied patients undergoing primary rhinoplasty with decreased nasal dorsum through open technique, divided into 2 groups: group 1, spreader grafts and group 2, spring flaps. All patients were previously and subsequently evaluated with physical and nasofibroscopy examination. Standardized research protocol was filled. All patients signed a free informed consent for research and surgery separately. Results: Surgical time was 20 minutes on average higher in group 1 patients. Resected septum area was higher in group 1 (428 mm2) than in group 2 (95.46 mm2). Group 1 showed more intraoperative complications (40%) than in group 2 (7%). In the clinical and nasofibroscopy evaluation, both techniques were effective in preserving airway function. Conclusion: Both techniques were capable of improving respiratory function, however, the spreader graft presented further complications.