Repair of the nasal septum perforation: Surgical strategy
DOI:
https://doi.org/10.34631/sporl.7Keywords:
Septum Perforation, Local Mucosal Grafts, Nasal EndoscopyAbstract
A nasal septum perforation is an abnormal communication between the right and left nasal cavities resulting from a complete loss of septal cartilage and/or bone and its overlaying mucoperichondrium/ mucoperiosteum on both septal sides. Prior septal surgery is, perhaps, the most common etiology in the Western World and, depending on its size and location, the absence of symptoms is frequent. More than 40 conflicting techniques are described in the literature for its surgical repair, with success rates from 40 to 95%. We discuss the advantages of using local composite grafts, with cartilage grafts and mucosal rotation flaps, under endoscopic visualization, for the closure of symptomatic septal perforations larger than 2cm.
References
-Chua DYK, Tan HKK. Repair of nasal septal perforations using auricular conchal cartilage graft in children: report on three cases and literature review. Int J Ped Otorhinolaryngol. 2006; 70: 1219-1224.
-Lanier B, Kai G, Marple B, Wall GM. Pathophysiology and progression of nasal septal perforation. Ann Allerg Asthma Immunol. 2007. 99: 473-48.
-Tasca I, Compadretti GC. Closure of septal perforation via endonasal approach. Otolaryngol Head Neck Surg. 2006; 135: 922-927.
-Oberg D, Akerlund A, Johansson L, Bende M. Prevalence of nasal septal perforation: the Skovde population-based study. Rhinology. 2003; 41: 72-75.
-Watson D, Barkdull G.. Surgical management of septal perforation. Otolaryngol Clin N Am. 2009; 42:483-493.
-André RF, Lohuis PJFM, Vuyk HD. Nasal septum perforation repair using differently designed, bilateral intranasal flaps, with nonopposing suture lines. J Plast Reconst AesthetSurg. 2006; 59: 829-834.
-Diamantopolus II, Jones NS. The investigation of nasal septal perforations and ulcers. J Laryngol Otol. 2001; 115: 541-544.
-Sang-Wook K, Chae-Seo R. Nasal septal perforation repair: predictive factores and systematic review of the literature. Curr Op Otolaryngol. 2012; 20: 1-8.
-Pedroza F, Patrocinio LG, Arevalo O. A Review of 25-year experience of nasal septal perforation repair. Arch Facial Plast Surg. 2007; 9: 12-18.
-Castelnuovo P, Ferreli F. Khodaei I, Palma P. Anterior Ethmoidal Artery Septal Flap for the Management of Septal Perforation. Arch Facial Plast Surg. 2011; 13: 411-414.
-Fairbanks D. Nasal Septal Perforations. Operat Techn Otolaryngol Head Neck Surg. 1991; 2:194-198.
-Pignatari S. Nogueira JF. Stamm AC. Endoscopic “crossover flap” technique for nasal septal perforations. Otolaryngol Head Neck Surg.2010; 142:132-134.
-Sclafani AP. Repair of large nasal septal perforations via the external rhinoplasty approach. Operat Techni Otolaryngol Head Neck Surg. 2011; 12: 20-24.
-Eliachar I. Mastros NP. Improved nasal septal prosthetic button. Otolaryngol Head Neck Surg. 1995; 112:347-349.
-Neumann A, Morales-Minovi C, Schultz-Coulon HJ. Closure of nasal septum perforations by bridge flaps. Acta Otorrinolaringol Esp. 2011; 62:31-39.
-Kazkayasi M, Yalcinozan ET. Uncinate process in the repair of nasoseptal perforation. Aesth Plast Surg. 2011; 35:878-881.
-Mon IJ, Kim SW, Han DH, Kim ST, et al. Predictive factores for the outcome of nasal septal perforation repair. Auris Nasus Larynx. 2011. 38:52-57.
-Giacomini PG, Ferraro S, Girolamo S, Ottaviani F. Large nasal septal perforation repair by closed endoscopically assisted approach. Ann Plas Surg. 2011; 66:633-636.
-Schultz-Coulon HJ. Three-layer repair of nasoseptal defects. Otolaryngol Head Neck Surg. 2005; 132:213-218.
-Teymoortash A, Hoch S, Eivazi B, Werner JA. Experiences with a new surgical technique for closure of large perforations of the nasal septum in 55 patients. Am J Rhinol Allergy. 2011; 25:193-197.
-Teymoortash A, Werner JA. Repair of nasal perforation using a simple unilateral inferior meatal mucosal flap. J Plast Reconstr Aesthet Surg. 2009; 62:1261-1264.
