Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

Septal Crossbar Graft versus Spreader Graft for Nasal Septal Deviation: A Triple-Blind Randomized Clinical Trial

Document Type : Original

Authors
Ali Goljanian Tabrizi
Mahboobe Asadi
Hossein Molaei
Department of Otolaryngology and Head and Neck Surgery, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
10.22038/ijorl.2026.96428.4171
Abstract
Introduction:
Nasal septal deviation (NSD) is a common problem that often requires surgical correction. Although spreader grafts are widely used in septorhinoplasty, evidence directly comparing them with septal crossbar grafts remains limited. This study aimed to compare these two techniques in patients with primary NSD.

Materials and Methods:
In this triple-blind randomized clinical trial, 68 patients were recruited from November 2024 to March 2025 and randomly assigned to undergo open septorhinoplasty using either a septal crossbar graft (n=34) or a spreader graft (n=34). Anatomical and functional outcomes were assessed preoperatively and six months postoperatively by measuring septal deviation angle correction via computed tomography and the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire, respectively.

Results:
Both techniques produced significant improvements in septal deviation and NOSE scores at six months (all p<0.001), which were comparable between groups (p>0.05). The mean NSD correction was 11.32±2.57° for septal crossbar graft and 12.76±3.84° for spreader graft. No postoperative complications were observed. Surgical duration was significantly longer with septal crossbar graft (3.72±0.44 vs. 2.02±0.52 hours, p<0.001). Multivariate regression analysis showed a significant independent effect of surgical technique favoring the septal crossbar graft while surgical duration imposed a significant negative impact concerning the anatomical correction.

Conclusion:
Both techniques provide safe and effective anatomical and functional improvements in patients with primary NSD. Although adjusted analyses favored the septal crossbar graft for septal correction, it was neutralized by its longer operative time, should be considered during surgical planning.
Keywords
Nasal septal deviation
Open septorhinoplasty
Septal crossbar graft
Spreader graft
Subjects
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Iranian Journal of Otorhinolaryngology
Volume 38, Issue 6
November and December 2026
Pages 383-392