The Role of Spreader Grafts in Reduction Septorhinoplasty: A Randomized Clinical Trial With Quality of Life Assessment.

Abstract

To evaluate the impact of spreader grafts in reduction septorhinoplasty on quality of life (QOL) outcomes. Randomized clinical trial (RCT). Individuals over 15 years old with nasal obstruction were evaluated for functional and aesthetic septorhinoplasty from October 2018 to October 2022 at a facial plastic surgery clinic of a tertiary university hospital in Brazil. Participants were randomly allocated to subjects with or without spreader grafts. Relative changes in specific Nasal Obstruction Symptom Evaluation in the Portuguese language (NOSE-p). Outcomes were assessed at least 6 and 12 months postoperatively (PO ≥ 6 and PO ≥ 12 m). The participants and those assessing the outcomes were blinded to group assignment. A 50 patients were included, 25 randomized to each group, mainly Caucasians with moderate/severe allergic rhinitis symptoms. Mean age was 32.89 ± 13.36 years and 68% were female. Septorhinoplasty improved specific quality-of-life scores irrespective of using spreader grafts (p < 0.001). There was no difference between subjects submitted or not to placement of spreader grafts in NOSE-p score in PO ≥ 6 m (-60.0 vs. -66.6%; p = 0.37); ROE in PO ≥ 6 m (71.83 vs. 79.56; p = 0.35), NO-VAS in PO ≥ 6 m (13.00 vs. 8.00; p = 0,35), NOSE p in PO ≥ 12 m (-53.14% vs. -68.33%; p = 0.28), ROE in PO ≥ 12 m (76.33 vs. 79.53; p = 0.645), NO-VAS in PO ≥ 12 m (13.00 vs. 11.50; p = 0.60). Reduction septorhinoplasty was associated with improvement in quality of life regarding nasal obstruction irrespective of using spreader grafts in a 7.88-month follow-up. ClinicalTrials.gov identifier: (NCT0449946).