Operationen an der inneren Nase

Denecke, Hans-Joachim; Ey, Werner

doi:10.1007/978-3-662-11522-0_2

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“…Damit es aber erst gar nicht zu einer bleibenden Septumperforation kommt, sollte Ziel jedes operativen Septumeingriffs sein, die Integrität der Schleimhaut zu erhalten und Läsionen bereits intraoperativ unverzüglich optimal zu versorgen. Einige Autoren führen sogar 2 /3 aller Septumdefekte auf eine iatrogene Manipulation zurück [2,6,10]. Einige Autoren führen sogar 2 /3 aller Septumdefekte auf eine iatrogene Manipulation zurück [2,6,10].…”

Section: Vorläufige Mitteilungunclassified

Prospektive Untersuchungen zur Spontanheilung von Septumschleimhauteinrissen bei rhinochirurgischen Eingriffen

Winter

Weissenrieder²,

Göde³

1999

HNO

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Mucosal lesions of the nasal septum during septal surgery are frequent, but there is scarce information in the literature about their outcome. In 283 operations of the nasal septum, 92 (32.5%) mucosal lesions occurred, 67 of these could be documented and classified 1, 3 and 6 months postoperatively. Although there was no therapy in 93% (74 cases) of the one-sided lesions, no permanent septal perforation was seen. A total of 7% (six cases) were treated by suture or lyophilised dura combined with tissue adhesive. On the other hand, double-sided and correspondent lesions (12 cases: six without therapy, four sutures, one lyophilised fascia, one tissue adhesive) showed a perforation in five cases without any symptoms. This represents 1.7% of all operations of the nasal septum and 7.4% of all recorded mucosal lesions of the nasal septum. Although the number of examinations are still few, it might be justifiable to conclude that one-sided lesions of the nasal septum need no specific therapy. All bilateral corresponding lesions, even those smaller than 5 mm, should be treated by one-sided suture in the anterior septum and with tissue adhesive in the posterior septum. The use of cartilage, bone or fascia alone is insufficient. Large defects of the mucosa should be treated by maximal therapy, i.e. covering with lyophilised fascia or dura, underlaying of cartilage or bone and using tissue adhesive.

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Section: Vorläufige Mitteilungunclassified