Use of the Spring Graft for Prevention of Midvault Complications in Rhinoplasty
Bibliographic record
Abstract
BACKGROUND: Preservation of the middle nasal vault has increasingly become a topic of interest and concern in rhinoplasty. Resection of even a minute amount of roof during hump removal disturbs the stabilizing effect of the upper lateral cartilages, which then causes a fall of upper lateral cartilages medially toward the anterior septal edge, restricting airflow at the internal valves and creating midvault problems. METHODS: The resected alar cartilages were placed deep to the upper lateral cartilages as a strengthened spring to prevent midvault collapse and internal valve incompetency. Although weak and small alar cartilages are limitations of the technique, the authors think that this is not so frequent because the total force exerted on the upper lateral cartilages by the spring graft is higher than the force of each individual two cartilage pieces. RESULTS: It was easy to view the widening of the internal valve and the smooth appearance of the middle third of the nose intraoperatively. All patients were satisfied with the results both functionally and aesthetically. CONCLUSIONS: The spring graft technique, a modification of the splay graft, handles both the functional and aesthetic problems in the dorsal midvault. The spring graft, with its advantages and disadvantages, is a technique that solves the frequently encountered problems of incompetent internal nasal valve and midvault collapse without the need for a second donor site. It is a simple, reliable technique that is easy to learn and execute and must be kept in mind in selected patients.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".