Anterior Ethmoidal Artery Septal Flap for the Management of Septal
                        Perforation

Castelnuovo, Paolo; Ferreli, Fabio; Khodaei, Iman; Palma, Pietro

doi:10.1001/archfaci.2011.44

Cited by 35 publications

(18 citation statements)

References 19 publications

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“…Castelnuovo described a closure technique utilizing a unilateral mucosal flap posterior to the perforation pedicled on the anterior ethmoid artery. 22 All 11 perforations measuring 1.0 to 2.5 cm were successfully closed. Perforation closures utilizing this flap have been modified to provide contralateral mucosal support for an additional layer of closure.…”

Section: Discussionmentioning

confidence: 95%

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Repair of Large Nasal Septal Perforations Using the Upper Lateral Cartilage Mucosal Flap

et al. 2021

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Objectives/Hypothesis To describe the surgical technique and closure outcomes of larger septal perforation repair incorporating mucosa from the undersurface of the upper lateral cartilage into a superiorly positioned advancement flap. Study Design Retrospective case series. Methods A chart review was performed for patients who underwent perforation repair utilizing bilateral nasal mucosal flaps which incorporated mucosa from the undersurface of the upper lateral cartilage into the superior flap between January 2009 and December 2020. Results Sixty‐six patients met study criteria. Prior septal surgery was the most common (28.8%) etiology. Mean perforation length and height were 18.9 and 14.4 mm, respectively. Complete perforation closure was noted in 91.2% of patients followed for a minimum of 6 months (mean follow‐up time 32.1 months). Twelve patients underwent secondary surgery for persistent nasal obstruction. Postoperative loss of dorsal height was noted in seven patients. The NOSE‐perf scores were available for the last 15 repairs and demonstrated significant symptom improvement from a mean score of 26.4 (95% confidence interval [CI], 5.2) to 14.5 (95% CI, 5.2) (P < .0001). Conclusion The ventral surface of the upper lateral cartilage can provide additional mucosa for incorporation into a superior advancement flap to achieve successful closure for larger septal perforations. Optimization of surgical outcomes for this challenging condition may require secondary functional or aesthetic procedures. Level of Evidence 4 Laryngoscope, 132:973–979, 2022

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Section: Discussionmentioning

confidence: 95%

“…Castelnuovo described a closure technique utilizing a unilateral mucosal flap posterior to the perforation pedicled on the anterior ethmoid artery 22 . All 11 perforations measuring 1.0 to 2.5 cm were successfully closed.…”

Section: Discussionmentioning

confidence: 99%

Repair of Large Nasal Septal Perforations Using the Upper Lateral Cartilage Mucosal Flap

et al. 2021

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“…This flap is useful for perforations not larger than 2 cm diameter. Because the nasal mucosa that is rotated anteriorly is the posterior one, is mostly used in anterior perforations [13].…”

Section: Anterior Ethmoidal Artery Septal Flapmentioning

confidence: 99%

“…The introduction of the concepts of vascular supply, arc of rotation and flap quality led to the design of techniques such as the inferior turbinate flap [12]. However, it was not until 2011, when the first pediculated septal flap based on the main branches of the ethmoidal artery was designed [13]. Since then, different versions of the anterior ethmoidal artery flap have been described [14 ▪ ], as well as other pedicle flaps such as the palatine artery flap [15 ▪ ] and the pericranial flap [4,16].…”

Section: Brief History and Development Of Septal Perforation Repairmentioning

confidence: 99%

State-of-the-art: septal perforation repair

Garaycochea

Santamaría‐Gadea

Alobid

2022

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of reviewTo provide a comprehensive overview of the evolution of the different techniques described for the surgical repair of nasal septal perforation, and a surgical decision-making algorithm for its surgical treatment. Recent findingsSeptal perforation surgery has evolved and improved in recent years. It has gone from being an avoided or discouraged surgical procedure to a procedure with success rates of >90%. Nowadays, there is no standard approach or single technique. The different techniques described include unilateral random pattern flaps, interposition grafts, unilateral pedicle septal local flaps, free mucosal grafts and bilateral random patter flaps. The incidence of success is higher in pediculated septal flaps such as the anterior ethmoidal artery flap or the greater palatine artery pedicled flap combined with additional techniques. SummaryNowadays, surgical closure of septal perforation is possible and should be an option to consider in symptomatic patients without response to medical treatment. The surgical approach that we recommend when planning the surgical closure of nasal septum (or nasoseptal) perforation is based on the osseocartilaginous support and the location of the defect.

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“…Many endoscopic techniques for NSP repair have been developed. Anterior ethmoidal artery flap is the most commonly used endoscopic technique with a high success rate 2,3 . Recently, Marino‐Sanchez et al 4 described a purely endoscopic surgical repair of NSP with a unilateral rotation septal flap pedicled to the greater palatine artery (GPA).…”

Section: Introductionmentioning

confidence: 99%