Use of spreader grafts
by Rajib Guy Kenyon, Rajib Dasgupta Kenyon

Jaypee’s Video Atlas of Operative Otorhinolaryngology AND Head & Neck Surgery

by Vicky S Khattar, Bachi T Hathiram
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Spreader grafts act as spacers in the internal valve region, i.e. between the caudal septum medially and the inferior turbinate laterally. They help improve nasal airflow in the internal valve area and are also useful in correcting asymmetries of the middle nasal vault, besides restoring dorsal esthetic lines. They are placed in a subperichondrial pocket that lies between the upper lateral cartilages and the septum. A pocket is created in the horizontal plane starting from the anterior septal angle and heading in a cephalic direction and ending at the keystone area. This pocket can be created by sharp dissection using a No. 15 scalpel blade and can be further developed using a Freer’s elevator. The upper lateral cartilages are dissected free from the septum preserving the underlying mucoperichondrium as far as possible. A rectangular cartilage graft of approximately 1 to 3 mm in thickness and 2 to 3 cm in length that extends from the keystone area to the anterior septal angle is then inserted and the grafts are secured in situ with horizontal mattress sutures above and below.

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