Repair of symptomatic nasoseptal perforations using mucosal regeneration technique with interpositional grafts

• Published in: The Journal of craniofacial surgery Vol. 25; no. 1; pp. 98 - 102
• Main Authors: Ozkul, Haluk M, Balikci, Hasan Huseyin, Karakas, Mustafa, Bayram, Ozlem, Bayram, Ali Alper, Kara, Nejla
• Format: Journal Article
• Language: English
• Published: United States 01-01-2014
• Subjects: Adult; Cartilage - transplantation; Dentistry; Ear Cartilage - surgery; Female; Follow-Up Studies; Humans; Male; Middle Aged; Mucociliary Clearance - physiology; Nasal Mucosa - physiology; Nasal Septal Perforation - surgery; Nasal Septum - surgery; Regeneration - physiology; Rhinoplasty - methods; Surgical Flaps - surgery; Tissue and Organ Harvesting - methods; Transplant Donor Site - surgery; Wound Healing - physiology
• ISSN: 1049-2275; 1536-3732
• DOI: 10.1097/SCS.0b013e3182a2eac6

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.