Experiences with a New Surgical Technique for Closure of Large Perforations of the Nasal Septum in 55 Patients

Teymoortash, Afshin; Hoch, Stephan; Eivazi, Behfar; Werner, Jochen A.

doi:10.2500/ajra.2011.25.3603

Cited by 38 publications

(31 citation statements)

References 14 publications

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“…In addition, our technique does not introduce added morbidity to the patient from obtaining mucosa from the nasal floor or oral mucosa, which can result in protracted healing at the donor site, cheek tightness, or stenosis of the internal nasal valve Table 4. [6][7][8][13][14][15][16][17][18] compares our technique with success rates of other SP closure techniques from the recent literature.…”

Section: Commentmentioning

confidence: 99%

Polyethylene Implants in Nasal Septal Restoration

Cho

Taylor

Deutschmann

et al. 2013

JAMA Facial Plast Surg

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eptal perforation (SP) is a common nasal disorder. A 2003 Swedish study 1 quoted a 0.9% prevalence of SP among the general population. The origin of SP is associated with the following 4 main causes: trauma, iatrogenesis, inflammation or malignancy, and inhalation. 2 Once the mucoperichondrium of the nasal septum becomes traumatized, diminished blood supply can lead to cartilaginous and mucosal necrosis. 3 Local reepithelialization of the mucosal edges then occurs, preventing closure of the defect. 4 Patients with SP may be seen with various symptoms and signs that often correspond to the size and location of the SP. An asymptomatic SP does not require any intervention. 5 Most symptomatic SPs are large and anterior, while posterior SPs tend to be less symptomatic due to humidification of the passing air by nasal mucosa and turbinates. 3 Common symptoms include nasal crusting, discharge, epistaxis, parosmia, neu-ralgia, and a whistling sound with inspiration. Some patients may manifest low-grade perichondritis, requiring long-term antibiotic therapy. Larger long-standing SPs can also cause atrophic rhinitis and saddle nose from a lack of nasal dorsal support. 2,6,7 Despite their being a common problem, SPs have been a distinctive challenge for otolaryngologists and facial plastic surgeons. Various techniques have been described to close SPs, and no single technique is recognized as being uniformly reliable in applying to all cases. 2 Furthermore, SP repair is often performed in noses that have already undergone surgery and have limited tissue and a compromised blood supply for reconstruction. Therefore, most SPs remain unclosed because available techniques are technically difficult and require extensive training and experience to master. IMPORTANCE Numerous techniques have been described to repair nasal septal perforations (SPs). However, many are technically challenging, with varying degrees of success. OBJECTIVE To evaluate the use of polyethylene (Medpor; Porex Technologies) implants in the closure of nasal SPs. DESIGN AND SETTING Prospective cohort study in an academic research setting.

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Section: Commentmentioning

confidence: 99%

Polyethylene Implants in Nasal Septal Restoration

Cho

Taylor

Deutschmann

et al. 2013

JAMA Facial Plast Surg

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“…SPs are usually classified by their location: anterior (areas I and II), central (areas III and IV), and posterior (area V) perforations, as well as cranial, central, and basal perforations . Unfortunately, previous septal surgery is still the most common cause of SPs . Therefore, most SPs are typically located in the anterior cartilaginous part of the septum (areas I and II according to Cottle) with the cartilage missing around the perforation .…”

Section: Introductionmentioning

confidence: 99%

Numerical simulation of airflow patterns in nose models with differently localized septal perforations

Lindemann

Rettinger

Kröger³

et al. 2013

The Laryngoscope

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The numerical simulations demonstrate significantly disturbed intranasal airflow patterns due to SPs. This fact may contribute to crusting and nosebleed due to dehydration of the nasal mucosa. The location and size of the SP are crucial for the impact on disturbed airflow pattern and therefore the patients' complaints. Anterior caudal SPs seem to be the worst. Surgical closure of SPs or simply changes in the site and size of the SP if a complete closure is surgically impossible makes sense.

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“…Symptoms tend to be related to the size and location of the perforation. In many cases of septal perforation, patients suffer from recurrent epistaxis, whistling, nasal obstruction, discharge, crusting, dryness, and pain [1]. Larger perforations can lead to atrophic rhinitis, a saddle nose deformity from a lack of dorsal nasal support, and can even result in squamous cell carcinoma [2,3].…”

mentioning

confidence: 99%

Effect of Temporal Fascia and Pedicle Inferior Turbinate Mucosal Flap on Repair of Large Nasal Septal Perforation via Endoscopic Surgery

He²,

Bai³

2016

ORL

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Background: The repair of large nasal septal perforations (NSPs) is one of the most challenging procedures in nasal surgery. The aim of this prospective clinical study was to determine the efficacy of using a pedicle inferior turbinate mucosal flap combined with temporal fascia to repair a large NSP. Method: Between January 2008 and December 2015, 17 consecutive patients with large NSPs underwent septal perforation repair via an endoscopic approach using a pedicle inferior turbinate mucosal flap combined with temporal fascia. Results: Complete closure of the perforation was achieved in all patients. Conclusion: The pedicle inferior turbinate mucosal flap combined with the temporal fascia technique can easily solve this challenging problem, and the current data from this prospective study suggest that this technique shows promising results.

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Experiences with a New Surgical Technique for Closure of Large Perforations of the Nasal Septum in 55 Patients

Abstract: Our experience with this flap shows its reliability and safety in repairing large nasal septal perforations, with many advantages compared with other techniques for septal perforation repair.

Cited by 38 publications

References 14 publications

Polyethylene Implants in Nasal Septal Restoration

Polyethylene Implants in Nasal Septal Restoration

Numerical simulation of airflow patterns in nose models with differently localized septal perforations

Effect of Temporal Fascia and Pedicle Inferior Turbinate Mucosal Flap on Repair of Large Nasal Septal Perforation via Endoscopic Surgery

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