2.  The internal nasal valve is the narrowest part of the nasal airway and its cross- sectional area is determined by the angle formed between the caudal part of the upper lateral cartilage and nasal septal cartilage  The average angle of the nasal valve in a normal Caucasian ranged from 9 to 15°

5.  Another limitation of spreader grafts is the need for long enough cartilage grafts usually harvested from the septal cartilage.

6.  Facial Plast Surg Clin North Am. 2004 Feb;12(1):107- 10. Overly wide cartilaginous middle vault. Thomas JR Thomas JR, Prendiville S.Prendiville S  In the setting of a wide middle vault, the reverse spreader technique is a useful alternative to dorsal augmentation, which creates the illusion of a narrower dorsum

7.  ’Neal and Berkowitz 1 in 1998 provided the first descriptive account of upper lateral cartilage flaps1  Someone uses them routinely utilized upper lateral cartilage flaps in all but the most minor (<1.5 mm) dorsal reductions

11.  This auto-spreader is a technique in which the mucoperichondrium of the underside of the upper lateral cartilage is elevated and then released from its cartilaginous

12.  This technique avoids harvesting and carving cartilage for grafting from other locations  This technique is limited in cases of deviated dorsal septum and asymmetric dorsal aesthetic lines

13.  Midvault reconstruction using the autospreader graft may help prevent postoperative nasal obstruction due to midvault collapse.  Combining this procedure with dorsal reduction in functional rhinoplasty patients with traditional airway reconstruction techniques is effective in improving nasal airway function as measured by a patient- based, disease-specific quality-of-life instrument.

16.  releasing the medial aspect of the upper lateral cartilage from the nasal bone, the caudal edge of the bone is exposed, allowing accurate placement of an osteotome.