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The Fulcrum Spreader Graft: A novel method for middle vault reconstruction

Ivo Gwanmesia MD, Rafael Couto MD, Gaby Doumit MD, Frank Papay MD
The Cleveland Clinic
2014-03-15

Presenter: Ivo Gwanmesia

Affidavit:
All the work for this project was done by the fellow

Director Name: Dr Frank Papay MD

Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics

THE FULCRUM SPREADER GRAFT: A NOVEL METHOD FOR MIDDLE VAULT RECONSTRUCTION
INTRODUCTION: Collapse of the internal nasal valve is a common cause of nasal obstruction. Spreader grafts are used to widen the internal nasal valve angle, and by so doing increase the cross sectional area of this part of the nose. We describe a novel method, the 'Fulcrum Spreader graft.'
AIMS AND OBJECTIVES: The aim of this paper was to describe this new technique, as well as to assess functional and aesthetic outcomes in a cohort of patients.
METHOD: 25 patients who underwent primary rhinoplasty between 2009 and 2014 were reviewed. Principal concerns were both functional and aesthetic. Pre and postoperative rhinometer measurements were taken and assessed. All middle vault reconstructions were performed using the fulcrum spreader graft technique. Functional and aesthetic outcomes were also assessed by means of a patient satisfaction survey. Values obtained were analyzed using a paired t-test with significance at p<0.05
RESULTS: Initial results suggest favorable functional outcomes in our ongoing study. Greater increases in cross sectional area are seen at CSA 2 and 3, with p values of 0.012 and 0.017 respectively.
CONCLUSION: Early results from our study suggest that reconstruction of the middle vault with the Fulcrum spreader graft provides satisfactory functional outcomes in patients.

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