Skip to main content
Erschienen in: European Archives of Oto-Rhino-Laryngology 1/2019

07.11.2018 | Rhinology

Microscopic approach for repairing nasal septal perforations using bilateral advancement flaps

verfasst von: José Miguel Villacampa Aubá, Alvaro Sánchez Barrueco, Gonzalo Díaz Tapia, Jessica Mireya Santillán Coello, Diego Armando Escobar Montatixe, Fernando González Galán, Ignacio Mahillo Fernández, Rocío González Márquez, Carlos Cenjor Español

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 1/2019

Einloggen, um Zugang zu erhalten

Abstract

Background

Septal perforations consist in an anatomic defect of the mucosal, cartilaginous and/or bone tissues of the nasal septum. A huge variety of approaches and techniques for nasal perforation repair have been reported.

Methodology/principal

Between January 2008 and January 2017, 38 patients were treated for nasal septal perforation in Department of Otorhinolaryngology Head and Neck Surgery, Fundación Jiménez Díaz University Hospital, Madrid, Spain. A novel approach is presented based on microscope. Septal perforation closure was performed with endonasal bilateral advancement flaps-established technique and autologous cartilage and muscle temporal fascia grafts. We performed a retrospective review of closure rates and complications.

Results

A postoperative follow-up of at least 12 months was performed in 37 patients. The mean size of perforation was 1.33 cm. After the withdrawal of the silicone splints, perforations were completely closed in all cases. However, during the follow-up, four patients resulted in a reperforation, so our closure rate was 89.19%. For all cases, symptoms related to septal defect were solved. Only one case was reported of local infections that was resolved with antibiotics in a few days.

Conclusions

Microscopic approach of septal perforation closure using bilateral advancement flaps can be an affordable technique with a high percent of success and low rate of complications.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Newton JR, White PS, Lee MS (2003) Nasal septal perforation repair using open septoplasty and unilateral bipedicled flaps. J Laryngol Otol 117(1):52–55 CrossRefPubMed Newton JR, White PS, Lee MS (2003) Nasal septal perforation repair using open septoplasty and unilateral bipedicled flaps. J Laryngol Otol 117(1):52–55 CrossRefPubMed
2.
Zurück zum Zitat Ayshford CA, Shykhon M, Uppal HS, Wake M (2003) Endoscopic repair of nasal septal perforation with acellular human dermal allograft and an inferior turbinate flap. Clin Otolaryngol Allied Sci 28(1):29–33 CrossRefPubMed Ayshford CA, Shykhon M, Uppal HS, Wake M (2003) Endoscopic repair of nasal septal perforation with acellular human dermal allograft and an inferior turbinate flap. Clin Otolaryngol Allied Sci 28(1):29–33 CrossRefPubMed
3.
Zurück zum Zitat Pedroza F, Patrocinio LG, Arevalo O (2007) A review of 25-year experience of nasal septal perforation repair. Arch Facial Plast Surg 9(1):12–18 CrossRefPubMed Pedroza F, Patrocinio LG, Arevalo O (2007) A review of 25-year experience of nasal septal perforation repair. Arch Facial Plast Surg 9(1):12–18 CrossRefPubMed
4.
Zurück zum Zitat Schultz-Coulon HJ (2005) Three-layer repair of nasoseptal defects. Otolaryngol Head Neck Surg 132(2):213–218 CrossRefPubMed Schultz-Coulon HJ (2005) Three-layer repair of nasoseptal defects. Otolaryngol Head Neck Surg 132(2):213–218 CrossRefPubMed
5.
Zurück zum Zitat Foda HM, Magdy EA (2006) Combining rhinoplasty with septal perforation repair. Facial Plast Surg 22(4):281–288 CrossRefPubMed Foda HM, Magdy EA (2006) Combining rhinoplasty with septal perforation repair. Facial Plast Surg 22(4):281–288 CrossRefPubMed
6.
Zurück zum Zitat Ribeiro JS, da Silva GS (2007) Technical advances in the correction of septal perforation associated with closed rhinoplasty. Arch Facial Plast Surg 9(5):321–327 CrossRefPubMed Ribeiro JS, da Silva GS (2007) Technical advances in the correction of septal perforation associated with closed rhinoplasty. Arch Facial Plast Surg 9(5):321–327 CrossRefPubMed
7.
Zurück zum Zitat Teymoortash A, Hoch S, Eivazi B, Werner JA (2011) Experiences with a new surgical technique for closure of large perforations of the nasal septum in 55 patients. Am J Rhinol Allergy 25(3):193–197 CrossRefPubMed Teymoortash A, Hoch S, Eivazi B, Werner JA (2011) Experiences with a new surgical technique for closure of large perforations of the nasal septum in 55 patients. Am J Rhinol Allergy 25(3):193–197 CrossRefPubMed
8.
Zurück zum Zitat Virkkula P, Makitie AA, Vento SI (2015) Surgical outcome and complications of nasal septal perforation repair with temporal fascia and periosteal grafts. Clin Med Insights Ear Nose Throat 8:7–11 CrossRefPubMedPubMedCentral Virkkula P, Makitie AA, Vento SI (2015) Surgical outcome and complications of nasal septal perforation repair with temporal fascia and periosteal grafts. Clin Med Insights Ear Nose Throat 8:7–11 CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Castelnuovo P, Ferreli F, Khodaei I, Palma P (2011) Anterior ethmoidal artery septal flap for the management of septal perforation. Arch Facial Plast Surg 13(6):411–414 CrossRefPubMed Castelnuovo P, Ferreli F, Khodaei I, Palma P (2011) Anterior ethmoidal artery septal flap for the management of septal perforation. Arch Facial Plast Surg 13(6):411–414 CrossRefPubMed
10.
Zurück zum Zitat Sarandeses-Garcia A, Sulsenti G, Lopez-Amado M, Martinez-Vidal J (1999) Septal perforations closure utilizing the backwards extraction–reposition technique of the quadrangular cartilage. J Laryngol Otol 113(8):721–724 CrossRefPubMed Sarandeses-Garcia A, Sulsenti G, Lopez-Amado M, Martinez-Vidal J (1999) Septal perforations closure utilizing the backwards extraction–reposition technique of the quadrangular cartilage. J Laryngol Otol 113(8):721–724 CrossRefPubMed
11.
Zurück zum Zitat Tasca I, Compadretti GC (2006) Closure of nasal septal perforation via endonasal approach. Otolaryngol Head Neck Surg 135(6):922–927 CrossRefPubMed Tasca I, Compadretti GC (2006) Closure of nasal septal perforation via endonasal approach. Otolaryngol Head Neck Surg 135(6):922–927 CrossRefPubMed
12.
Zurück zum Zitat Andre RF, Lohuis PJ, Vuyk HD (2006) Nasal septum perforation repair using differently designed, bilateral intranasal flaps, with nonopposing suture lines. J Plast Reconstr Aesthet Surg 59(8):829–834 CrossRefPubMed Andre RF, Lohuis PJ, Vuyk HD (2006) Nasal septum perforation repair using differently designed, bilateral intranasal flaps, with nonopposing suture lines. J Plast Reconstr Aesthet Surg 59(8):829–834 CrossRefPubMed
13.
Zurück zum Zitat Re M, Paolucci L, Romeo R, Mallardi V (2006) Surgical treatment of nasal septal perforations. Our experience. Acta Otorhinolaryngol Ital 26(2):102–109 PubMedPubMedCentral Re M, Paolucci L, Romeo R, Mallardi V (2006) Surgical treatment of nasal septal perforations. Our experience. Acta Otorhinolaryngol Ital 26(2):102–109 PubMedPubMedCentral
14.
Zurück zum Zitat Presutti L, Alicandri Ciufelli M, Marchioni D, Villari D, Marchetti A, Mattioli F (2007) Nasal septal perforations: our surgical technique. Otolaryngol Head Neck Surg 136(3):369–372 CrossRefPubMed Presutti L, Alicandri Ciufelli M, Marchioni D, Villari D, Marchetti A, Mattioli F (2007) Nasal septal perforations: our surgical technique. Otolaryngol Head Neck Surg 136(3):369–372 CrossRefPubMed
15.
Zurück zum Zitat Hanci D, Altun H (2015) Repair of nasal septal perforation using middle turbinate flap (monopedicled superiory based bone included conchal flap): a new unilateral middle turbinate mucosal flap technique. Eur Arch Otorhinolaryngol 272(7):1707–1712 CrossRefPubMed Hanci D, Altun H (2015) Repair of nasal septal perforation using middle turbinate flap (monopedicled superiory based bone included conchal flap): a new unilateral middle turbinate mucosal flap technique. Eur Arch Otorhinolaryngol 272(7):1707–1712 CrossRefPubMed
16.
Zurück zum Zitat Romo T III, Sclafani AP, Falk AN, Toffel PH (1999) A graduated approach to the repair of nasal septal perforations. Plast Reconstr Surg 103(1):66–75 CrossRefPubMed Romo T III, Sclafani AP, Falk AN, Toffel PH (1999) A graduated approach to the repair of nasal septal perforations. Plast Reconstr Surg 103(1):66–75 CrossRefPubMed
17.
Zurück zum Zitat Kim SW, Rhee CS (2012) Nasal septal perforation repair: predictive factors and systematic review of the literature. Curr Opin Otolaryngol Head Neck Surg 20(1):58–65 CrossRefPubMed Kim SW, Rhee CS (2012) Nasal septal perforation repair: predictive factors and systematic review of the literature. Curr Opin Otolaryngol Head Neck Surg 20(1):58–65 CrossRefPubMed
18.
Zurück zum Zitat Cottle MH, Loring RM (1948) Surgery of the nasal septum; new operative procedures and indications. Ann Otol Rhinol Laryngol 57(3):705–713 CrossRef Cottle MH, Loring RM (1948) Surgery of the nasal septum; new operative procedures and indications. Ann Otol Rhinol Laryngol 57(3):705–713 CrossRef
19.
Zurück zum Zitat Moon IJ, Kim SW, Han DH, Kim ST, Min YG, Lee CH et al (2011) Predictive factors for the outcome of nasal septal perforation repair. Auris Nasus Larynx 38(1):52–57 CrossRefPubMed Moon IJ, Kim SW, Han DH, Kim ST, Min YG, Lee CH et al (2011) Predictive factors for the outcome of nasal septal perforation repair. Auris Nasus Larynx 38(1):52–57 CrossRefPubMed
20.
Zurück zum Zitat Dosen LK, Haye R (2011) Surgical closure of nasal septal perforation. Early and long term observations. Rhinology 49(4):486–491 PubMed Dosen LK, Haye R (2011) Surgical closure of nasal septal perforation. Early and long term observations. Rhinology 49(4):486–491 PubMed
21.
22.
Zurück zum Zitat Lee HR, Ahn DB, Park JH, Kim YH, Sin CM, Youn SJ et al (2008) Endoscopic repairment of septal perforation with using a unilateral nasal mucosal flap. Clin Exp Otorhinolaryngol 1(3):154–157 CrossRefPubMedPubMedCentral Lee HR, Ahn DB, Park JH, Kim YH, Sin CM, Youn SJ et al (2008) Endoscopic repairment of septal perforation with using a unilateral nasal mucosal flap. Clin Exp Otorhinolaryngol 1(3):154–157 CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Beckmann N, Ponnappan A, Campana J, Ramakrishnan VR (2014) Posterior septal resection: a simple surgical option for management of nasal septal perforation. JAMA Otolaryngol Head Neck Surg 140(2):150–154 CrossRefPubMed Beckmann N, Ponnappan A, Campana J, Ramakrishnan VR (2014) Posterior septal resection: a simple surgical option for management of nasal septal perforation. JAMA Otolaryngol Head Neck Surg 140(2):150–154 CrossRefPubMed
24.
Zurück zum Zitat Kridel RW (1999) Septal perforation repair. Otolaryngol Clin N Am 32(4):695–724 CrossRef Kridel RW (1999) Septal perforation repair. Otolaryngol Clin N Am 32(4):695–724 CrossRef
Metadaten
Titel
Microscopic approach for repairing nasal septal perforations using bilateral advancement flaps
verfasst von
José Miguel Villacampa Aubá
Alvaro Sánchez Barrueco
Gonzalo Díaz Tapia
Jessica Mireya Santillán Coello
Diego Armando Escobar Montatixe
Fernando González Galán
Ignacio Mahillo Fernández
Rocío González Márquez
Carlos Cenjor Español
Publikationsdatum
07.11.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
European Archives of Oto-Rhino-Laryngology / Ausgabe 1/2019
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-018-5169-z

Weitere Artikel der Ausgabe 1/2019

European Archives of Oto-Rhino-Laryngology 1/2019 Zur Ausgabe

Update HNO

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.