Skip to main content Accessibility help

A novel technique for spreader graft placement without dorsum resection during septoplasty

  • E Kaya (a1), T Catli (a2), H Soken (a3) and C Cingi (a1)



This paper presents a novel method for spreader graft placement without dorsum resection in patients who have a deviated septum with a narrow internal nasal valve angle.


A Killian incision was used for the endonasal septoplasty, and all spreader grafts were harvested from excised deviated septal cartilages. Procedures were conducted under general anaesthesia at the same centre by the same surgical team that performed the endonasal procedure. Successful placement of spreader grafts was achieved endonasally.


Although the endonasal placement of spreader grafts seems to be more difficult than placement conducted by an open approach technique, an endonasal procedure has many advantages. Our technique provides surgeons with the opportunity to shorten operation time, obtain autologous septal graft material and secure the columellar architecture. Surgeons familiar with the classical (endonasal) septoplasty procedure can easily apply this technique to widen a narrow internal nasal valve angle, without corrupting nasal integrity.


Corresponding author

Address for correspondence: Dr Tolgahan Catli, Department of Otorhinolaryngology, Bozyaka Teaching and Research Hospital, Saim Cikrikci Street, Bozyaka, Izmir, Turkey Fax: +90 232 2505051 E-mail:


Hide All
1Sheen, JH. Spreader graft: a method of reconstructing the roof of the middle nasal vault following rhinoplasty. Plast Reconstr Surg 1984;73:230–9
2Manavbasi, I, Agaoglu, G. Endonasal placement of spreader grafts. Plast Reconstr Surg 2007;119:1961–2
3Teichgraeber, JF, Wainwright, DJ. The treatment of nasal valve obstruction. Plast Reconstr Surg 1994;37:1183–4
4Grigoryants, V, Baroni, A. The use of short spreader grafts in rhinoplasty for patients with thick nasal skin. Aesthetic Plast Surg 2013;37:516–20
5Miman, MC, Deliktas, H, Ozturan, O, Toplu, Y, Akarçay, M. Internal nasal valve: revisited with objective facts. Otolaryngol Head Neck Surg 2006;134:41–7
6Wittkopf, M, Wittkopf, J, Ries, WR. The diagnosis and treatment of nasal valve collapse. Curr Opin Otolaryngol Head Neck Surg 2008;16:1013
7Reiffel, AJ, Cross, KJ, Spinelli, HM. Nasal spreader grafts: a comparison of medpor to autologous tissue reconstruction. Ann Plast Surg 2011;66:24–8
8Yoo, DB, Jen, A. Endonasal placement of spreader grafts: experience in 41 consecutive patients. Arch Facial Plast Surg 2012;14:318–22
9Pontius, AT, Williams, EF 3rd.Endonasal placement of spreader grafts in rhinoplasty. Ear Nose Throat J 2005;84:135–6
10Toriumi, DM, Josen, J, Weinberger, M, Tardy, ME Jr.Use of alar batten grafts for correction of nasal valve collapse. Arch Otolaryngol Head Neck Surg 1997;123:802–8
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed