Repair of symptomatic nasoseptal perforations using mucosal regeneration technique with interpositional grafts.
Over the past 60 years, many surgical techniques have been developed for the repair of nasoseptal perforations. This study describes a safe and practical technique involving the 5-layer repair of symptomatic nasoseptal perforations without mucosal flaps. The present study involved 23 patients (17 men and 6 women) who had symptomatic nasoseptal perforations in the Otorhinolaryngology and Head Neck Surgery Department of Haseki Research and Training Hospital. Patients were treated using the mucosal regeneration technique. Follow-up examinations were performed at 3 and 6 months postoperatively. The surgery was considered successful if total closure was achieved. Nasal mucosal physiology was also assessed preoperatively and at 3 and 6 months postoperatively by measuring the nasal mucociliary clearance time by means of the saccharin test. The most common etiological factor was former nasal surgery (56.5%), followed by nasal trauma (26%). In 4 patients (17.5%), the perforations were idiopathic. The average preoperative perforation size was 1.74 ± 0.87 cm. Total closure of the perforation was achieved in 21 patients (91.3%), and only 2 patients had subtotal healing. The mean preoperative mucociliary clearance time was 19.3 ± 4.15 minutes, which significantly improved to 12.4 ± 3.53 minutes and 10.1 ± 3.21 minutes at 3 and 6 postoperative months, respectively. Mucosal regeneration technique with interpositional grafts can be used to safely and reliably repair medium-to-large nasoseptal perforations.
From the *Department of ORL, Haseki Teaching and Research Hospital, Istanbul; and †Department of ORL, Susehri Government Hospital, Sivas, Turkey.
Haluk M
HM
Ozkul
Hasan Huseyin
HH
Balikci
Mustafa
M
Karakas
Ozlem
O
Bayram
Ali Alper
AA
Bayram
Nejla
N
Kara
D000328:Adult; D002356:Cartilage / Q000637:transplantation*; D004425:Ear Cartilage / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009079:Mucociliary Clearance / Q000502:physiology; D009297:Nasal Mucosa / Q000502:physiology; D061270:Nasal Septal Perforation / Q000601:surgery*; D009300:Nasal Septum / Q000601:surgery; D012038:Regeneration / Q000502:physiology; D012225:Rhinoplasty / Q000379:methods; D013524:Surgical Flaps / Q000601:surgery; D020858:Tissue and Organ Harvesting / Q000379:methods; D060053:Transplant Donor Site / Q000601:surgery; D014945:Wound Healing / Q000502:physiology