Endonasal septal perforation repair using posterior and inferiorly based mucosal rotation flaps

Dayton, Steven R.; Chhabra, Nipun; Houser, Steven M.

doi:10.1016/j.amjoto.2017.01.001

Cited by 16 publications

(16 citation statements)

References 6 publications

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“…Nasal septal perforations (NSPs) are a complete anatomic defect of the nasal septum incorporating the mucosa as well as the cartilaginous or osteocartilaginous septum. [1][2][3] In the literature, perforations have been typically classified as small ( 0.5 cm), medium (0.5-2 cm), and large (>2 cm), 1,4 but there is no general consensus in categorizing the size and location of NSPs. Many etiologies can lead to a perforation including local trauma, chondritis, inhalant irritants, septal hematoma, infection, neoplasms, substance abuse, iatrogenic causes, and autoimmune diseases.…”

Section: Introductionmentioning

confidence: 99%

“…Many etiologies can lead to a perforation including local trauma, chondritis, inhalant irritants, septal hematoma, infection, neoplasms, substance abuse, iatrogenic causes, and autoimmune diseases. [1][2][3]5,6 Iatrogenic causes, such as complications from routine procedures such as septoplasty, are considered the most common cause of NSP. 2,7,8 The symptoms vary in intensity from mild to severe and can greatly affect quality of life.…”

Section: Introductionmentioning

confidence: 99%

“…A recent study reported that 85% of patients with NSP are symptomatic. 2 Septal perforations located anteriorly are more likely to cause discomfort due to turbulent airflow. 2,3 Patients may also report dryness, crusting, whistling, discharge, epistaxis, nasal obstruction, pain, and cosmetic deformity.…”

Section: Introductionmentioning

confidence: 99%

“…2 Septal perforations located anteriorly are more likely to cause discomfort due to turbulent airflow. 2,3 Patients may also report dryness, crusting, whistling, discharge, epistaxis, nasal obstruction, pain, and cosmetic deformity. [1][2][3][4]6,7 Although posterior perforations are usually asymptomatic, 7 crusting is the most common complaint.…”

Section: Introductionmentioning

confidence: 99%

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Septal Perforation Repair Utilizing an Anterior Ethmoidal Artery Flap and Collagen Matrix

Cavada

Orgain

Alvarado

et al. 2018

Am J Rhinol�Allergy

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Background Nasal septal perforation repair remains a challenge with no standard technique for repair recognized. Objective To describe the combination of an anterior ethmoidal artery flap with a collagen matrix inlay as a successful technique for nasal septal perforation repair. Methods A case series of consecutive patients who underwent nasal septal perforation repair with an anterior ethmoidal artery flap with an inlay collagen graft was conducted. Demographic data, preoperative features of the perforation (size, location, and presence of chondritis), and postoperative outcomes were analyzed; closure rate, mucosalization rate (of the contralateral side at 21 and 90 days), and complications (crusting, bleeding, obstruction, infection, and rehospitalization <30 days) were documented. Results Thirteen patients (age: 49 ± 15 years, 30.8% women) were assessed. The perforation size was 1.6 ± 0.9 cm (range: 0.3–3.5 cm) and located 1.2 ± 0.5 cm (range: 0.5–2.0 cm) posterior to the columella. Chondritis was present in 69.2%. The closure rate was 100% (95% confidence interval [CI]: 77%–100%) at both 21 and 90 days. One patient required a free mucosa graft to an area of persistent crusting on the contralateral side (7.7%). Complications were low; bleeding 0%, obstruction 7.7% (requiring corticosteroid injection of anterior ethmoidal artery flap), and 0% infection/rehospitalization. Conclusion Anterior ethmoidal artery flap with an inlay collagen matrix is a reliable technique to repair nasal septal perforation. This technique, with robust vascularity and wide angle of rotation, enables the closure of perforations both large (<50% total septum) and with anterior locations.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Septal Perforation Repair Utilizing an Anterior Ethmoidal Artery Flap and Collagen Matrix

Cavada

Orgain

Alvarado

et al. 2018

Am J Rhinol�Allergy

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“…Options for surgical closure are related to the size and location; small anterior septal perforations can be successfully closed endonasally, and larger defects benefit from the open rhinoplasty approach with interpositional grafts or several flap choices . Some of the flaps described in the literature include: alar winged flap, mucosal rotation flaps, inferior turbinate flap, labiobuccal flap, skin flaps, and others . In a systematic review, Kim and Rhee found that interpositional graft tends to have the greatest success and reduce reperforation rates…”

mentioning

confidence: 99%

Custom Nasal Septum Prosthesis Fabricated from a 3D‐Printed Working Model: A Clinical Report

Marquez

2019

Journal of Prosthodontics

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This clinical report describes the treatment of a 47-year-old female patient with a nasal septum perforation. The treatment used a 2-piece magnetic custom prosthesis fabricated from a 3D-printed model. By using an existing medical CT scan to generate the printed working model, the number of clinical appointments was reduced. The workflow expanded the purpose of the radiologic images from simply diagnostic to include the prosthetic aspect of treatment.

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Surgical repair of nasal septal perforations: A systematic review and meta‐analysis

Fermin

Bui

McCoul

et al. 2022

Int Forum Allergy Rhinol

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Background: A wide variety of techniques for the surgical repair of nasal septal perforations (NSPs) have been described. Surgical management of NSPs can be broadly divided into open versus endonasal approaches, with additional variables involving unilateral or bilateral flaps, use of grafts, and placement of splints. The objective of this study was to compare surgical approaches and their outcomes. Methods: PubMed, EMBASE, and CINAHL Plus databases were examined for patients undergoing NSP repair. English-language studies reporting surgical management of patients with the primary diagnosis of NSP were included. Outcome measures of interest included perforation size, surgical approach characteristics, and success rate defined as complete closure assessed by surgeon postoperatively. The quality of articles was assessed with the methodological index for nonrandomized studies (MINORS) criteria. A random-effects model was used to calculate pooled proportions for the different outcomes. Results:The electronic database search yielded 1076 abstracts for review. A total of 64 articles met the inclusion criteria, with 1591 patients: 1127 (71%) underwent an endonasal approach and 464 (29%) an open approach. The median (range) MINORS score was 10 (5-12) out of 16 points. Overall, 91% of patients had total closure (95% confidence interval [CI], 0.89-0.93, p < 0.01), with moderate heterogeneity between studies (I 2 = 42.03%). There was no difference in closure success between open and endonasal approaches. Use of bilateral versus unilateral flaps, interposition grafts, and intranasal splints and packing were not associated with differences in outcomes. Conclusion:Nasal septal perforation surgical repair success rates are comparable regardless of technique.

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Endonasal septal perforation repair using posterior and inferiorly based mucosal rotation flaps

Cited by 16 publications

References 6 publications

Septal Perforation Repair Utilizing an Anterior Ethmoidal Artery Flap and Collagen Matrix

Septal Perforation Repair Utilizing an Anterior Ethmoidal Artery Flap and Collagen Matrix

Custom Nasal Septum Prosthesis Fabricated from a 3D‐Printed Working Model: A Clinical Report

Surgical repair of nasal septal perforations: A systematic review and meta‐analysis

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