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Outcome of surgical closure of nasal septal perforation

Published online by Cambridge University Press:  20 May 2010

S Wong  and
U Raghavan
S Wong*
Affiliation:
Department of Otorhinolaryngology, Doncaster Royal Infirmary, UK
U Raghavan
Affiliation:
Department of Otorhinolaryngology, Doncaster Royal Infirmary, UK
*
Address for correspondence: Miss Smeeta Wong, 8 Nursery Grove, Alwoodley, Leeds LS17 7AL, UK. E-mail: [email protected]
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Abstract

Objective:

To assess success rates and symptom control after surgical treatment of nasal septal perforation.

Method:

A prospective study was undertaken of 28 consecutive patients with symptomatic nasal septal perforation treated surgically by one surgeon between 2005 and 2007. All patients underwent an open rhinoplasty approach with bilateral superior and inferior nasal mucosal advancement flaps and acellular porcine collagen placed in between. Symptom severity was assessed pre- and post-operatively using a validated visual analogue score. The nasal valve angle was assessed pre- and post-operatively by two independent assessors.

Results:

Patients comprised 12 women and 16 men, with a mean age of 45 years (range: 21–76). The mean follow up was 16 months (range: 6–24). The mean vertical and horizontal diameters of the perforations were 22 mm (range: 10–35) and 27 mm (range: 10–37), respectively. Twenty-seven (96 per cent) patients had complete closure of nasal septal perforation. There were statistically significant differences between the pre- and post-operative mean visual analogue scale scores for epistaxis (p < 0.001), crusting (p < 0.001), whistling (p < 0.001) and nasal obstruction (p < 0.001). Epistaxis, crusting and whistling resolved in all patients, and 92 per cent reported improvement in nasal blockage.

Conclusion:

Closure of nasal septal perforation using an open rhinoplasty approach with nasal mucosal advancement flaps and a porcine collagen sandwich is a pertinent and reliable technique for the management of nasal septal perforation.

Keywords

Nasal Septal PerforationSurgeryMucosal FlapsPorcine Collagen
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 8 , August 2010 , pp. 868 - 874
Copyright
Copyright © JLO (1984) Limited 2010

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Footnotes

Presented at the 7th Annual British Rhinology Society Meeting, 23 May 2008, Liverpool, UK.

References

1 Foda, HM. The one-stage rhinoplasty septal perforation repair. J Laryngol Otol 1999;113:728–33CrossRefGoogle ScholarPubMed
2 Brain, D. The nasal septum. In: Rhinology volume, Scott-Brown's Otolaryngology Head and Neck Surgery, 5th edn. editors Mackay, Ian, Bull, TR, Butterworth international, London, 1987;154–79Google Scholar
3 Barraclough, JP, Ellis, D, Proops, DW. A new method of construction of obturators for nasal septal perforations and evidence of outcomes. Clin Otolaryngol 2007;32:42–59CrossRefGoogle ScholarPubMed
4 Goy, HS, Husain, SS. Different surgical treatments for nasal septal perforation and their outcomes. J Laryngol Otol 2007;121:419–26Google Scholar
5 Newton, JR, White, PS, Lee, SW. Nasal septal perforation repair using open septoplasty and unilateral bipedicle flaps. J Laryngol Otol 2003;117:52–5CrossRefGoogle Scholar
6 Gollom, J. Perforation of the nasal septum – the reverse flap technique. Arch Otolaryngol 1968;88:518–19CrossRefGoogle ScholarPubMed
7 Tardy, ME Jr. “Practical suggestions on facial plastic surgery – how I do it”. Sublabial mucosal flap: repair of septal perforations. Laryngoscope 1977;87:275–8CrossRefGoogle Scholar
8 Fairbanks, DN. Closure of nasal septal perforations. Arch Otolaryngol Head Neck Surg 1980;106:509–13CrossRefGoogle ScholarPubMed
9 Vyuk, HD, Versluis, RJJ. The inferior turbinate flap repair for closure of nasal septal perforations. Clin Otolaryngol 1988;13:53–7CrossRefGoogle Scholar
10 Hussain, A, Murthy, P. Modified tragal cartilage – temporoparietal and deep temporal fascia sandwich graft technique for repair of nasal septal perforations. J Laryngol Otol 1997;111:435–7CrossRefGoogle ScholarPubMed
11 Kridel, RWH, Foda, H, Lunde, KC. Septal perforation repair with acellular human dermal allograft. Arch Otolaryngol Head Neck Surg 1998;123:73–8CrossRefGoogle Scholar
12 Nunez-Fernadez, D, Vokyrka, J, Chrobok, V. Bone and temporalis fascia graft for the closure of nasal septal perforation. J Laryngol Otol 1998;112:1167–71CrossRefGoogle Scholar
13 Permacol® Surgical Implant. In: http://www.pulmonmedical.com/surgicalproducts/permacol/permacolindex.htm [15 March 2008]Google Scholar
14 Pedroza, F, Patrocinio, LC, Arevalo, O. A review of 25-year experience of nasal septal perforation repair. Arch Facial Plast Surg 2007;9:1–7CrossRefGoogle ScholarPubMed
15 Woolford, TJ, Jones, NS. Repair of nasal septal perforations using local mucosal flaps and a composite cartilage graft. J Laryngol Otol 2001;115:22–5CrossRefGoogle Scholar