A Comparison of the Functional Efficacy of the Spreader Graft and Spreader Flap Techniques Used in Open Rhinoplasty Based on Nasal Obstruction Symptoms Evaluation (NOSE) Scores

The aim of this study was to measure postoperative functional satisfaction in patients who underwent spreader graft or spreader flap procedures using the standardized Nasal Obstruction Symptoms Evaluation Score (NOSE) and to compare the 2 methods. Preoperative and early (1–3 mo), middle (4–6 mo), and late (≥9 mo) postoperative NOSE scores were compared in patients who underwent open rhinoplasty with the spreader graft (group 1) or spreader flap (group 2) techniques at our hospital. The patients’ demographic and surgical data were also analyzed. The study involved 63 patients who met the inclusion criteria. The spreader flap technique was used in 34 cases (29% female, mean age: 27.0±4.7 y) and the spreader graft in 29 (31% female, mean age: 26.2±5.4 y). The mean NOSE scores improved significantly in both groups at postoperative early evaluations (21.4±9.5 in the spreader flap and 18.7±14.9 in the spreader graft groups) compared with preoperative values (77.6±13.7 in the spreader flap and 76.9±15.4 in the spreader graft groups) (P<0.001). However, there were no significant differences in evaluations among the early, middle, and late postoperative periods. The study results revealed no significant difference between spreader graft and flap use in terms of improvement in functional outcomes. Both techniques are therefore functionally effective in rhinoplasty. Copyright © 2026 by Mutaz B. Habal, MD