Spreader graft in closed rhinoplasty: the "rail spreader"

Scattolin A, Orlando N, D'Ascanio L.

What this paper says

This report describes a custom-shaped spreader graft, the "rail spreader," and a method for placing and fixing it through the closed approach, where precise fixation of spreader grafts has been difficult; the abstract reports no patient counts or outcomes.

Overview

Spreader grafts hold the middle of the nose open and prevent collapse after a hump is removed. In open rhinoplasty they are easy to stitch in place; in closed rhinoplasty the limited view makes placement awkward and discourages surgeons from using them. The authors present a graft shape and insertion method designed for the endonasal approach.

Sections of note

Technical report; no series size, follow-up, breathing measurements or complications appear in the abstract.
Spreader grafts are used for both aesthetic and functional reasons: preventing middle vault collapse and treating internal valve insufficiency.
The rail spreader is a custom-made graft with a personal, easy application method for endonasal rhinoplasty.
Technical details and results are reported in the article, with claimed advantages over previously described approaches.

What it means for a patient

Surgeons who prefer closed rhinoplasty have ways to place the internal support grafts that protect breathing after hump removal.
The abstract does not report how patients breathed or looked afterward.
Whether this graft holds position as well as a sutured open-approach graft is not shown in the abstract.

Why this paper matters

Difficulty placing spreader grafts is one argument for the open approach; techniques like this one aim to remove it. Outcome data would be needed to judge whether it matches open placement.

Terms

Spreader graft: a cartilage strip placed between the septum and upper lateral cartilage to hold the middle vault open.
Closed (endonasal) rhinoplasty: rhinoplasty through incisions hidden inside the nostrils.
Middle vault: the cartilage section of the bridge between the nasal bones and the tip.
Internal nasal valve: the narrowest part of the airway, between the septum and upper lateral cartilage.
Fixation: securing a graft so it does not move during healing.
Custom-made graft: a graft carved to a specific shape for the technique.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“Spreader grafts (SGs) have been widely used for both aesthetic and functional reasons to prevent middle vault collapse and treat internal nasal valve insufficiency. Although SG precise fixation can be easily achieved in open rhinoplasty, the difficulties of SG placement in closed rhinoplasties can be discouraging. In…”

Excerpt; the full abstract is on PubMed.