Pull up spreader graft to a tip support effect

Nasal airway obstruction can be associated to a deviated septum or nasal valve collapse with or without anatomical obstructions (polyps). Furthermore, the architectural defect can involve the aesthetics of the nasal dorsum and tip. The purpose of the Author is a new technique of simultaneous spreader grafting of the nasal vault and the rotation of the tip in the desired position. 10 patients affected by light (4) to severe (6) nasal obstruction were treated from 2001 to 2003 with a new technique of nasal spreading. This technique is performed with an open approach. The upper part of the lateral crus is splitted androtated medially and therefore inserted in a precise pocket between thenasal septum and the upper lateral. The cartilages are fixed pulling upthe nasal domes and tip with PDS 5-0. The dorsal part of the lateralcrus can be adjusted with a scalpel creating a supratip break and tipsupport. Also the spreading gives an anatomically related quantity ofcartilage and dorsal enlargement. There is no scarring and no need ofcartilage harvesting, all 10 patients had an improvement in nasal airway (scale 1 to 10), 6 patients with a clinical score of 7 and 4 patients with a clinical score of 10. Nobody complained for the open approach scarring and all had a good aesthetic result, with a stable upward rotation of the tip after 2 years. Nor displacement of the sutured cartilagen neither infections or hematoma was observed in 100% of patients, we propose a new technique of nasal spreading that cannot substitute the conventional use of dorsal spreaders, but can be an aid in cases of thin