Objectives/Hypothesis Recent developments in reconstructive techniques for mucosal defects using mucoperiosteal materials have enabled rapid recovery of physiological function after endoscopic sinus surgery. Clinical trials have described the advantages, disadvantages, and different outcomes of free graft and pedicled flap, which, respectively, sacrifice or preserve blood flow. However, histological changes, that affect the postoperative outcomes after reconstruction, remain unclear. We created an animal model for the reconstruction of mucosal defects using free grafts and pedicled flaps, and evaluated them histologically. Study Design Animal study. Methods We created mucosal defects in the left nasal septum of 20 rabbits and performed reconstruction with free grafts and pedicled flaps. The distribution of ciliary and goblet cells at the reconstruction site was evaluated after 7 and 28 days using hematoxylin and eosin–stained sections to calculate the Ciliary Cell Index and Goblet Cell Index. The severity of inflammation was assessed using the Cartilage Inflammatory Cell Score. Results Crusting and changes in the mucosal morphology at the reconstruction site occurred only in the free graft group. In addition, the pedicled flap group had significantly greater preservation of ciliary and goblet cells and less inflammatory cell infiltration into the septal cartilage (P < .05) than the free graft group. Conclusions After reconstruction procedures for mucosal defects, histopathological differences were observed between the free graft and pedicled flap. Reconstruction with pedicled flaps had advantages including preservation of healthy mucosal epithelium and suppression of inflammation on the reconstruction site. This indicated that reconstruction with pedicled flaps might have advantages over that with free grafts. Level of Evidence NA Laryngoscope, 131:E428–E433, 2021
Several types of flap techniques have been developed to cover exposed bone after Draf procedures to reduce the possibility of re-stenosis. These techniques are relatively new and detailed measurements of the size of neo-Ostia during follow-up have not been reported. The authors aim to assess outcomes precisely by not only using endoscopic evaluation but also by measuring the diameter of the ostium and the thickness of the nasal beaks on pre- and postoperative computed tomography images. The authors reviewed 25 patients with 37 nasal cavities who have undergone a Draf surgery with a previously-reported superior lateral anterior pedicle flap technique. The anteroposterior (AP) distance of the frontal recess and the thickness of the nasal beaks were measured before, immediately after, and more than 6 months after surgery. Measured distances were statistically analyzed. The neo-ostium remained patent in long-term follow-up of all patients. The AP distance of the frontal recess and the thickness of the nasal beak were preserved during follow-up. Neither synechiae nor orbital injuries occurred. In conclusion, Draf type II and III procedures with superior lateral anterior pedicle flaps are safe and effective. Neo-Ostia remained patent throughout the follow-up period.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.