Endoscopic Repairment of Septal Perforation with Using a Unilateral Nasal Mucosal Flap

Lee, Hye-Ryung; Ahn, Dongbin; Park, Jihyun; Kim, Yee-Hyuk; Sin, Chang-Min; Youn, Sung-Jae; Kim, Jung-Soo

doi:10.3342/ceo.2008.1.3.154

Cited by 48 publications

(39 citation statements)

References 18 publications

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“…Also, the open septoplasty technique allows work easily to create the nasal mucosal flaps bilaterally and gives a far better chance for total closure of the NSP. [1,4,10,13,15,19] The technique presented herein for the surgical closure of nasal septal perforations, combines several components of previously described techniques, and uses recognized surgical principles. Although this technique is not always necessary for smaller ones, it is our procedure of choice.…”

Section: (A) (B) (C) (D)mentioning

confidence: 99%

Closure of nasal septal perforations using bilateral intranasal advancement/rotation flaps

Özdek

Bayır²,

Dündar³

et al. 2014

Kulak Burun Bogaz Ihtis Derg

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Objectives: This study aims to report our experience on surgical repair of nasal septal perforations (NSP) using bilateral intranasal advancement/rotation flaps with open septoplasty technique. Patients and Methods:Medical records of 28 consecutive patients who were operated for NSP in our clinic between January 2009 and February 2013 were retrospectively analyzed. Demographic features of the patients and surgical results were evaluated. Results:The most common cause of NSP was previous septal surgery in 18 (64%) of the patients. Nasal crusting was the most common symptom in 21 patients (75%). Perforation size ranged from 10 to 30 mm in diameter. Septoplasty was performed in five patients, while septorhinoplasty was performed in three patients simultaneously to the NSP repair. Nasal septal cartilage and auricular chonchal cartilage were used to support the nasoseptal skeleton, if required. There were no major intra-or postoperative complications. The mean postoperative follow-up period was 23 months. During follow-up, there was mild columellar retraction in five patients (18%). Nasal septal perforation was closed successfully in 24 patients (86%). Pinpoint perforation remained in two patients and perforation size was smaller than 5 mm in two patients. Conclusion:Closing the NSP with bilateral intranasal advancement/rotation flaps has a comparable high success rate. Therefore, this technique can be easily applied to small-medium sized septal perforations.Keywords: Nasal septum; nasal septum perforation; reconstructive surgical procedure; surgical flap.Amaç: Bu çalışmada açık teknik septoplasti yoluyla iki taraflı burun içi ilerletme/rotasyon flepleri kullanılarak uygulanan nazal septal perforasyon (NSP) onarımındaki deneyimimiz sunuldu. Bulgular: Nazal septal perforasyonun en sık nedeni 18 hastada (%64) daha önce geçirilmiş nazal septum cerrahisi idi. En sık görülen semptom 21 hastada (%75) burun içerisinde kabuklanma idi. Perforasyon çapı 10-30 mm arasında değişmekteydi. Nazal septal perforasyon tamiri ile birlikte aynı zamanda beş hastada septoplasti, üç hastada septorinoplasti uygulandı. Nazoseptal iskeleti desteklemek amacı ile gerekli olduğu durumlarda nazal septal kartilaj ve aurikula konkal kartilaj kullanıldı. Ameliyat sırası ya da sonrası majör komplikasyon ile karşılaşılmadı. Ameliyat sonrası ortalama takip süresi 23 ay idi. Takip sürecinde beş hastada (%18) kolumellar retraksiyon görüldü. Nazal septal perforasyon 24 hastada (%86) başarı ile kapatıldı. Pinpoint perforasyon iki hastada görülürken, iki hastada perforasyon 5 mm'nin altında idi.Sonuç: İki taraflı burun içi ilerletme/rotasyon flepleri kullanılarak uygulanan NSP kapama kıyaslanabilir düzeyde yüksek başarı oranına sahiptir. Bu nedenle, bu teknik özellikle küçük ve orta çaplı perforasyonlara kolaylıkla uygulanabilir.Anahtar Sözcükler: Nazal septum; nazal septum perforasyonu; rekonstrüktif cerrahi işlem; cerrahi flep.

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Section: (A) (B) (C) (D)mentioning

confidence: 99%

Closure of nasal septal perforations using bilateral intranasal advancement/rotation flaps

Özdek

Bayır²,

Dündar³

et al. 2014

Kulak Burun Bogaz Ihtis Derg

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“…The radial forearm free flap has also been used successfully to resurface the nasal and maxillary cavities in two cases of refractory epistaxis in patients with Osler‐Rendu‐Weber disease 22. Although fascial free flap transfers have commendable outcomes, albeit with significant risk of free tissue transfer, nasal mucosal flaps have the benefit of replacing nasal mucosa with native nasal mucosal, theoretically reducing the crust formation associated with non–self‐clearing skin and the need for intranasal lavage 22–25…”

Section: Discussionmentioning

confidence: 99%

Reducing nasal morbidity after skull base reconstruction with the nasoseptal flap: Free middle turbinate mucosal grafts

et al. 2012

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Introduction The nasoseptal flap provides hearty, vascularized tissue for reconstruction of Expanded Endonasal Approaches (EEA); however, it produces donor site morbidity due to exposed cartilage. Mucosalization of the septum requires 12 weeks, multiple debridements, and frequent saline rinses. This study addresses the reduction of nasal morbidity by grafting middle turbinate mucosa onto the exposed septum. Methods 15 patients undergoing EEA of the ventral skull base were prospectively enrolled. In seven cases, the sacrificed middle turbinate mucosa was harvested and placed as a free mucosal graft on the septal cartilage. In eight controls middle turbinate grafting was not performed due to tumor involvement. Septal mucosalization and crusting of all patients was quantified at follow-up appointments. An additional 46 patients were retrospectively identified who received middle turbinate grating on their exposed septal cartilage and mucosalization rates determined from clinical records. Results Three weeks after initial operation, the mucosalization rate was 70% versus 5% in the graft and non-graft groups, respectively. At post-operative week six, the mucosalization and crusting were 97% and 5% for the graft group versus 60% and 85% for the non-graft group. Mucosalization rates in the retrospective graft series agreed with the prospective series. Conclusions Despite donor site morbidity, the nasoseptal flap is becoming the standard of care for skull base reconstruction due to its reliability in reestablishing a barrier between the subarachnoid space and the sinonasal tract. It is possible to dramatically increase the rate of septal mucosalization and decrease crusting by using a middle turbinate free mucosal graft. Level of Evidence 1b

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“…18 Bir di ğer ça lış ma da 14 sep tal per fo ras yon lu has tanın te da vi sin de tem po ral kas fas ya gref ti ile kom bine tek ta raf lı iler let me mu ko za fle bi kul la nıl mış ve %85,7 ora nın da tam ka pan ma el de edil miş tir. 14 …”

Section: Tar Tiş Maunclassified

Outcome of Septal Perforation Repair Using a Rotational Mucosal Flap Technique

Sağlam¹,

Çetin²,

Karapinar³

et al. 2014

Turkiye Klinikleri J Med Sci

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Endoscopic Repairment of Septal Perforation with Using a Unilateral Nasal Mucosal Flap

Cited by 48 publications

References 18 publications

Closure of nasal septal perforations using bilateral intranasal advancement/rotation flaps

Closure of nasal septal perforations using bilateral intranasal advancement/rotation flaps

Reducing nasal morbidity after skull base reconstruction with the nasoseptal flap: Free middle turbinate mucosal grafts

Outcome of Septal Perforation Repair Using a Rotational Mucosal Flap Technique

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