Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr;134(4):1638-1641.
doi: 10.1002/lary.31069. Epub 2023 Oct 14.

Cadaveric Assessment of the Butterfly Graft in Rhinoplasty

Affiliations

Cadaveric Assessment of the Butterfly Graft in Rhinoplasty

Benjamin P Brownlee et al. Laryngoscope. 2024 Apr.

Abstract

Introduction: The rhinoplasty butterfly graft is used to improve the internal nasal valve (INV), but post-operative visibility remains a concern. Intraoperative techniques have developed to thin the graft with unknown effect on functionality.

Objectives: Improve understanding of how to modify the aesthetics of the butterfly graft without impacting patient outcomes. Determine how graft contouring affects its biomechanical properties.

Methods: Cadaveric cartilage grafts were used to examine the biomechanics in its native state and with progressive thinning. The force needed to stabilize the INV in an unaltered state and the resistance force provided by native (original), partially thinned, and fully thinned cartilage grafts were recorded.

Results: The mean thickness of grafts in their natural state was 1.64 mm, median 1.50 mm (SD 0.64 mm). The fully-thinned mean was 0.84 mm, median 0.8 mm (SD 0.18 mm). The mean force (N) of the native graft was 0.74 N and 0.60 N for fully thin (p = 0.016, 95%). The mean force (N) needed to stabilize the INV was 0.15 N (right) and 0.19 N (left).

Conclusion: Butterfly grafts can be thinned by approximately 50% of their original thickness and retain the strength to stabilize the INV.

Level of evidence: NA Laryngoscope, 134:1638-1641, 2024.

Keywords: butterfly graft; internal nasal valve; nasal valve stenosis; rhinoplasty.

PubMed Disclaimer

References

BIBLIOGRAPHY

    1. Clark JM, Mims MM. The Butterfly Graft. Rhinoplasty Archive; 2020.
    1. Clark DW, Del Signore AG, Raithatha R, Senior BA. Nasal airway obstruction: prevalence and anatomic contributors. Ear Nose Throat J. 2018;97(6):173-176.
    1. Howard BE, Madison CJ. Evolution of the butterfly graft technique: 15-year review of 500 cases with expanding indications. Laryngoscope. 2019;129(S1):S1-S10.
    1. Hismi A, Burks CA, Locascio JJ, Lindsay RW. Comparative effectiveness of cartilage grafts in functional rhinoplasty for nasal sidewall collapse. Facial Plast Surg Aesthet Med. 2022;24(3):240-246.
    1. Sinkler MA, Wehrle CJ, Elphingstone JW, Magidson E, Ritter EF, Brown JJ. Surgical management of the internal nasal valve: a review of surgical approaches. Aesthetic Plast Surg. 2021;45(3):1127-1136. https://doi.org/10.1007/s00266-020-02075-5 Epub 2021 Jan 5. PMID: 33399950.

Publication types

LinkOut - more resources