The Reconstruction of Nasal Septal Perforation with High Density Porous Polyethylene Covered with Fascia Lata: An Experimental Study on Rabbit Model

Abstract

ObjectivesEvaluation of a new material, high-density porous polyethylene (HDPP), which is covered with fascia lata, for experimental nasal septal perforation closure.MethodsTwenty New Zealand albino rabbits were included and divided into study and control groups. A lateral incision was made from the lateral aspect of the left nares to the incisura nasomaxillaris. After exposure of the cavum nasi, the nasal mucoperichondrium was elevated bilaterally. A full-thickness 0.5×0.5-cm perforation was created over the septum nasi with a No. 11 surgical blade. A fascia lata graft was used for the study group. The HDPP was covered with fascia lata and placed under the elevated mucosa. HDPP without a fascial covering was used in the control group. Four months after the procedure, magnetic resonance imaging was performed to evaluate resorption of the material. The animals were sacrificed, and the nasal septum was completely removed. Macroscopic and histopathological examinations were performed on the nasal septum.ResultsAll rabbits had survived after the 4-month period. Macroscopically, nine of 10 (90%) perforations were closed in the fascia lata-covered HDPP group. Histopathological examination of these nine rabbits revealed that the continuity of cartilage was disturbed in the perforation areas. Granulation tissue was inverted in areas in which the cartilage continuity was disturbed. The HDPP had remained intact at the edge of the perforation. In the HDPP group, six of 10 implants were still perforated (60%) and four (40%) were closed. The fascia lata-covered HDPP implant had a significantly higher perforation closure rate than that of the HDPP implant alone (P<0.05).ConclusionIn cases of septal perforation, it is better to cover the HDPP implant with fascia lata. This covered implant can be used for the repair of nasal septal perforations. HDPP implants are easy to work with and avoid the increased operative time and morbidity associated with harvesting autografts.

In VitroCytotoxicity andIn VivoEffects of a Decellularized Xenogeneic Collagen Scaffold in Nasal Cartilage Repair

“…Studies on nasal septum pathophysiology and repair in rabbits have been published with various experimental backgrounds. [36][37][38][39][40][41] Most of these studies aimed at the evaluation of implantable materials for nasal septum reconstruction. Tissue-engineering techniques have just been applied once for this purpose so far.…”

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

“…[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.…”

“…[5] The majority of symptomatic NSPs require surgery, but there is no standard surgical approach in NSP closure, which still remains a surgical challenge. [6] Various surgical techniques have been described for the surgical repair of NSP including open technique septoplasty, endonasal, sublabial and midfacial degloving approaches depending on the size of NSP. Different types of flaps have been designed to reconstruct the nasal septum.…”

Investigation of the effects of fascia lata on neochondrogenesis in a rabbit model

“…In a study on nasal septal perforation, fascia lata was used due to the requirement for a very low metabolic activity which allows tissue growth and vascularization on its surface. [13] In studies performed, fascia lata has been recommended as a non-antigenic ideal donor graft. [21,22] In this study autologous fascia lata graft was used.…”

“…The advantages of fascia lata include, its acceptance by the surrounding tissue without any complication, its biocompatibility and its collagenous and regenerative characteristics. [10][11][12][13] In this study, the impact of fascia lata on perichondrial neochondrogenesis developed in defective areas of cartilages was investigated in a rabbit septum model.…”