Nasoseptal Perforation: from Etiology to Treatment

Abstract

NSP prevalence is about 1%. Clinical presentation may range from absence of symptoms to the presence of bothersome sinonasal symptoms. NSP is more frequently caused by trauma or post-surgery, inflammatory diseases, and abuse substances. Conservative management (nasal irrigation, topical use of antibiotic or lubricant ointments, or placement of prosthesis) is considered the first-line treatment. Symptomatic NSP not improving with local therapies usually requires surgical approach. Selection of the technique for the endoscopic septal repair depends on perforation characteristics and surgeon experience. When NSP is diagnosed, its cause has to be promptly determined. Most of them can be controlled with conservative measures. Surgical/endoscopic approaches are usually needed in refractory cases, and new repair techniques have to be considered.

Resultados postoperatorios de cierre quirúrgico de perforación septal con injertos de cartílago.

“…La técnica quirúrgica para el cierre de perforación septal es un procedimiento desafiante para el cirujano y a la fecha no existe un abordaje estándar. Por tanto, la elección de esta depende del soporte osteocartilaginoso y de la experiencia del cirujano (15). El éxito quirúrgico depende de diferentes variables como el tamaño y la localización de la perforación, la cantidad de cartílago presente y la presencia de tejido cicatricial mucoso (6).…”

“…Se ha descrito una gran variedad de abordajes quirúrgicos con diferentes tasas de éxito: desde rotación o transposición de colgajos mucosos (tasas de éxito desde 60 %-89 %) (10,12), colgajos de cornete inferior (tasas de éxito reportadas entre 30 % y 70 %) (13,15,16,18) y avance de colgajos bipediculados (tasa de éxito del 100 %) (18,19). No obstante, raramente se puede realizar el cierre completo con ambos colgajos mucopericóndricos particularmente en pacientes con perforaciones de gran tamaño, lo cual se ha evidenciado como un factor asociado con la perforación septal residual en un 48 % de los pacientes (8).…”

Untitled

“…The most common cause of these patients is nose bleed, nasal congestion and nasal dryness. Rarely, there are complaints of sound extraction similar to whistling [1,2].…”

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

“…A nasal septum perforation has been described as a communication between the 2 nasal cavities and produced by the necrosis of the mucoperichondrium and the mucoperiosteum; subsequently the necrosis of the cartilage and bone can be observed . Some authors have estimated the prevalence in the general population to be close to 1% .…”

“…A nasal septum perforation has been described as a communication between the 2 nasal cavities and produced by the necrosis of the mucoperichondrium and the mucoperiosteum; subsequently the necrosis of the cartilage and bone can be observed . Some authors have estimated the prevalence in the general population to be close to 1% . Gold et al in 2017 investigated the prevalence of nasal perforations in an urban hospital setting and found a 2.1% prevalence on CT imaging, with the most common risk factor being a history of drug abuse …”