Surgical Treatment Using an Allograft Dermal Matrix for Nasal Septal Perforation

Abstract

PurposeNumerous methods have been utilized to repair nasal septal perforation with varying degrees of success; however, no consensus has been reached on nasoseptal perforation repair. Here, the authors describe a surgical method based on human dermal allograft (Surederm™, Hans Biomed Corp. Korea) for the repair of nasal septal perforations.Materials and MethodsEleven patients with a nasal septal perforation were included in this study. The causes of these septal perforations included previous nasal surgery, trauma, foreign body (button battery), and idiopathy. There were several sites of perforation: 9 in the central area, 1 in the posterior-central area, and 1 in the anterior area. An interpositional graft incorporating Surederm™ was positioned between bilateral mucoperichondrial flaps using an intranasal approach. A silastic sheet was then left in the nasal septum bilaterally until complete healing had occurred through new nasal mucosa, which took a mean duration of 6 weeks.ResultsOutcomes in ten of the eleven patients were successful, with complete septal perforation closure. The remaining perforation, which was caused by a button battery, closed incompletely; however, its initial size of 2 cm was reduced to 5 mm.ConclusionThe described technique has a high success rate and can be performed under local anesthesia without external scarring. In the absence of donor site morbidity, this technique can also be utilized to repair posterior or multiple septal perforations without difficulty.

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

“…[3] Additionally, chronic nasal obstruction and mucus stagnation due to damage of mucociliary activity lead to functional problems. [12] While whistling may be seen in small perforations due to turbulence of airflow through the perforation, dryness and bleeding may also be determined in large perforations. [14] Therefore, surgery should be included in the treatment not only to close the perforations, but also to restore or protect normal anatomical structures and physiological functions.…”

“…[14] Therefore, surgery should be included in the treatment not only to close the perforations, but also to restore or protect normal anatomical structures and physiological functions. [3,12] Many successful studies have been reported over decades using intranasal mucosal or mucoperichondrial flaps. [1][2][3][4][5]7,8] Different success rates have been described in literature with those for bilateral intranasal flaps better than those for unilateral intranasal flaps especially when combined with autogenous connective tissue graft and open septoplasty technique.…”

“…[7] Recently, some graft materials have been used for interposition between the mucosal flaps to support the NSP closure such as titanium membrane, biphasic calcium phosphate, acellular human allograft conchal cartilage, septal bone, acellular dermal graft, uncinate process, deep temporal fascia and fascia lata graft with high density porous polyethylene. [6,[8][9][10][11][12][13] The purpose of this study is to report our experience with surgical repair of NSP.…”

Xenogeneic acellular dermal matrix in combination with pectoralis major myocutaneous flap reconstructs hypopharynx and cervical esophagus

“…ADM, initially utilized in burn surgery, has then been applied in plastic surgery [6,7], abdominal hernia repair [8,9], and oral mucosal defect repair [10]. In addition, multiple studies have found ADM to be gradually and successfully utilized in otolaryngology-head and neck surgery of nasal septal perforation [11][12][13], tympanic membrane perforation [14], and postoperative defect of oropharyngeal and hypopharyngeal.…”

Application of a Composite Skin Equivalent using Collagen and Acellular Dermal Matrix as the Scaffold in a Mouse Model of Full-thickness Wound

“…특히 무세포진피는 진피 특징적인 3차원 망상구조, 생 장인자, 1형, 4형, 7형 등의 콜라겐과 elastin, proteoglycan, basement membrane complex로 이루어져 있어 세포적합성, 조직적 합성이 뛰어나고 연조직 특유의 물성으로 다양한 치 료에 적용되고 있다 [8]. 또한 조직재건 및 미용성형, 전층부 창상, 화상 등 피부치료제로써의 이용범위도 확대되고 있다 [9][10][11]. 그러나 사체기증의 어려움 및 합성고분자 치료제에 비교해 동일면적 대비 고가의 가격으로 인해 선택의 폭이 좁 은 실정이다 [12].…”