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Spare Roof Technique Can Improve Patient Quality of Life after Rhinoplasty

by Amy E. Hamaker •

What are the aesthetic and functional outcomes of the first 100 patients who underwent reduction rhinoplasty with the spare roof technique (SRT)?

Bottom Line: SRT significantly improved patient quality of life regarding nose function and appearance.

Background: The majority of Caucasian aesthetic rhinoplasty patients complain about a noticeable hump in profile view. However, dorsal hump reduction can create both aesthetic and functional problems if performed incorrectly. Through the SRT, the surgeon isolates the entire cartilaginous roof of the middle third, separating the quadrangular septum from the upper lateral cartilages (ULCs) without splitting the ULCs among them.

Study design: Prospective, interventional, and longitudinal study performed on consecutive patients undergoing primary rhinoplasty by SRT.

Setting: Department of Otolaryngology, Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Portugal.

Synopsis: The study population included a total of 100 Caucasian Mediterranean patients (33 males; 67 females). An open approach was used in 18 patients, and a closed approach was used in the remaining 82. Cartilage powder for refining the nasal dorsum was placed in 87 patients. SRT was performed for dehumping in 69 patients, and dehumping and correcting crooked nose in 31 patients. Analysis of the preoperative and postoperative mean aesthetic visual analogue scale (VAS) scores showed a significant improvement from 3.67 to 8.1 and 8.44, respectively, at three and 12 months postsurgery. Analysis of both preoperative and postoperative mean aesthetic VAS scores after rhinoplasty showed a small but significant improvement. Analysis of the five aesthetic Likert scale questions all showed a highly significant improvement after rhinoplasty. There was a statistically significant positive correlation between aesthetic VAS and the subjective body image in relation to nasal appearance improvements. Limitations included a study population containing more women than men, and aesthetical evaluation of the appearance of the nose that may be influenced by nonnasal aesthetical factors.

Citation: Santos M, Rego AR, Coutinho M, Almeida e Sousa C, Ferreira MG. Spare roof technique in reduction rhinoplasty: prospective study of the first one hundred patients. Laryngoscope. 2019;129:2702–2706.