The effect of spreader graft use on voice in rhinoplasty cases: a prospective randomized controlled study.

Summary

In a double-blind RCT, spreader grafts mitigated adverse postoperative changes in higher formant frequencies (F3–F4) and prevented deterioration in VHI-10 scores, whereas rhinoplasty without grafts showed significant acoustic and subjective voice changes. These findings support graft placement when voice quality is a priority.

Key Findings

• With spreader grafts, only F3 and F4 for /m/ changed postoperatively; without grafts, shimmer, jitter, and multiple formant values (F2–F4 for /n/; F3–F4 for /m/) changed significantly.
• Postoperative between-group differences were significant for F4 (/m/), F3 (/n/), and F3 (nasalized /i/).
• VHI-10 scores increased (worsened) only in the no-graft group, indicating subjective voice deterioration prevented by graft use.

Clinical Implications

For patients who rely on voice (e.g., singers, actors, teachers), consider spreader grafts and counsel about potential voice changes; integrate pre/postoperative acoustic assessment and VHI-10 monitoring.

Limitations

• Sample size not reported in the abstract; potential underpowering for some endpoints.
• Short follow-up (3 months) limits understanding of long-term voice outcomes; single-center design may affect generalizability.

Future Directions

Conduct multicenter RCTs with larger samples and ≥12-month follow-up, including professional voice users, to validate durability and refine patient selection.