The Role of Spreader Grafts in Management of Middle Third Crooked Nose

Objective: To compare between the use of spreader grafts and the other methods used to straighten the middle third crooked nose as regard function and aesthetic results as well as their hazards. Material and Methods: Following Institutional Review Board approval, 30 patients who were referred to our institution complaining from middle thrid crooked nose and fitting certain pre-operative inclusion criteria were treated with use of spreader graft and non spreader techniques between September 2006 and August 2008, with minimum follow-up period of six months. Results: 12 (80%) patients of spreader grafts group had been centeralized middle third of their crooked nose while 3 (20%) patients suffered from minimal deviation and 15 (100%) had marked significatant improvement in their nasal resistance by comparing the results of their rhinometeric results pre-operatively to post-operative state. 10 (66.7%) patients of non-spreader group had been centeralized middle third of their crooked nose while 5 (33.3%) patients suffered from minimal deviation and 15 (100%) had only significatant improvement in their nasal resistance by comparing the results of their rhinometeric results pre-operatively to post-operative state. Conclusion: In cases with mild to moderate deviation of crooked nose, the non-spreader techniques, may be used with obtaining satisfactory results both function and aesthetic. On the other hand, in cases with moderate to severe deviation of crooked nose and associated anatomical deformities, the spreader grafts technique is the most ideal method for straightening of such crooked nose with also improving the function of the nose as well as Spreader grafts are accepted to be a standard for reconstructing the middle third of the nose.