The inverted ‘V’ deformity and collapse of the ‘middle vault’

An explanation of the inverted ‘V’ deformity and how spreader grafts prevent collapse of the middle vault and widen the internal valve. Usually done through an ‘open’ rhinoplasty approach although Jack Sheen, who popularized this technique, always inserted spreader grafts through a closed rhinoplasty approach.

spreader-grafts

‘At the end of the XIX century, Mink is the one to suggest the concept of Nasal Valve (NV) as the narrow opening formed between the caudal (lower)portion of the superior or upper lateral cartilage (SLC) and the nasal septum, a 10 to 15º angle as the region of maximum nasal resistance. In 1965, Van Dishoeck confirms this hypothesis from Mink and locates the NV in a coronal plane at the junction of the superior lateral and septal cartilages.’

inverted ‘V’ deformity

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