Evaluation of the Effect of Conventional Rhinoplasty with Autospreader Flap and Let-Down Technique on Nasal Functions

Taş BM, Erden B.

What this paper says

Comparing 27 patients having conventional rhinoplasty with autospreader flaps against 27 having the let down preservation technique, both groups improved significantly on breathing and quality of life scores with no difference between them.

Overview

The study compared two ways of managing the nasal bridge. The let down technique lowers the natural bridge after removing a high strip of septum, while conventional rhinoplasty folds the upper cartilages inward as autospreader flaps after taking the hump down. Fifty four patients were divided into two equal groups and assessed with the NOSE and SNOT-22 questionnaires before and after surgery.

Sections of note

Comparative study of 54 patients, 27 per group.
Group 1 had open septorhinoplasty with an autospreader flap; group 2 had let down rhinoplasty with high septal strip resection.
The NOSE scale measures nasal obstruction; the SNOT-22 measures nasal and sinus quality of life.
Both scales were completed before and after surgery.
Postoperative values were significantly lower, meaning better, than preoperative values in both groups, P less than 0.001.
No significant difference was found between the two groups on either scale, P greater than 0.05.
There was no significant difference between groups in age or gender.

What it means for a patient

Both approaches improved self reported breathing and nasal quality of life.
Neither approach outperformed the other on these measures.
Twenty seven patients per group is small, so a modest real difference could go undetected.
The abstract states no follow up interval and reports no objective airflow measurement.

Why this paper matters

Preservation techniques are promoted partly on the claim of better breathing than conventional hump removal. This study puts the two side by side using validated questionnaires and finds them equivalent. Larger and longer comparisons would be needed to settle the functional claim.

Terms

Let down technique: lowering the nasal framework after removing a wedge of bone at each side.
Autospreader flap: folding the patient's own upper cartilages inward to keep the airway open, instead of adding a graft.
High septal strip resection: removing a strip of septum just under the bridge so it can settle down.
NOSE: the Nasal Obstruction Symptom Evaluation questionnaire.
SNOT-22: the Sino Nasal Outcome Test, a 22 item quality of life questionnaire.

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

From the abstract

“Let-down technique, in which high septal strip resection is performed, and conventional rhinoplasty using autospreader flaps were compared regarding nasal functions with Nasal Obstruction Symptom Evaluation (NOSE) and Sinonasal Outcome Test-22 (SNOT-22) quality-of-life scale questionnaires. A total of 54 patients who…”

Excerpt; the full abstract is on PubMed.