Pathological Features of Free Graft and Pedicled Flap in the Nasal Cavity: An Animal Study

Tochigi, Kosuke; Omura, Kazuhiro; Miyashita, Keisuke; Aoki, Satoshi; Otori, Nobuyoshi; Tanaka, Yasuhiro

doi:10.1002/lary.28630

Cited by 8 publications

(22 citation statements)

References 37 publications

(105 reference statements)

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“…Therefore, to prevent these postoperative complications, many treatments are performed to recover mucosal function at the mucosal defect site 9,24,25 . Even if the exposed bone is re‐epithelialized, if the epithelium becomes squamous metaplasia, the nasal physiological function disappears, and the mucociliary clearance ability is impaired 9,14 . As a result, crusts adhere, causing symptoms such as offensive odor, nasal congestion, and post‐nasal drip, and impair the patient's quality of life (QOL) 7 .…”

Section: Discussionmentioning

confidence: 99%

“…Rabbits were anesthetized with an intravenous injection of medetomidine (1.0 mg/kg, FUJIFILM Wako Pure Chemical Corp., Osaka, Japan), midazolam (5 mg/kg, Sando, Tokyo, Japan), and butorphanol (1.0 g/kg, Meiji Seika Pharm Co., Tokyo, Japan). Following a previous study, a midline incision was made on the dorsum of the nose, and lateral incisions were made in the nasal bone to expose the left nasal septum 14 …”

Section: Methodsmentioning

confidence: 99%

“…In addition to local and pedicled mucosal flaps with feeding blood flow, free mucosal grafts without feeding blood flow are used to reconstruct mucosal defects in the nasal cavity 8,10,12 . Both methods aim to maintain nasal physiology at the reconstruction area; however, blood flow to the mucosal materials used for reconstruction is essential for the regeneration of ciliary and goblet cells to maintain nasal physiology 7,13,14 . Owing to differences in the feeding blood flow to mucosal materials, the pedicled mucosal flap is superior to the free mucosal graft in the recovery of nasal physiological functions 14 .…”

Section: Introductionmentioning

confidence: 99%

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Mucosal Epithelial Preservation of Free Nasal Grafts Depending on the Recipient Site

et al. 2021

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Objectives/Hypothesis Reconstruction of mucosal defects using free mucosal grafts has become a common procedure during endoscopic sinus surgery. Epithelialization of mucosal grafts affects postoperative complications and outcomes, which could be influenced by different recipient tissue. However, morphological changes occurring in the grafts transplanted over different tissues remain unexplored. Study Design An animal study. Methods Free mucoperichondrial grafts were prepared from the nasal septum of rabbits; the cartilage group had reconstruction on the nasal septal cartilage, and the perichondrium group had reconstruction on the contralateral perichondrium. The nasal septum was removed after 1 and 4 weeks of reconstruction, and the graft was histologically evaluated. Results After 1 week of reconstruction, the mucosal epithelium of grafts in the cartilage group disappeared, whereas the columnar epithelium of grafts was preserved in the perichondrium group. After 4 weeks of reconstruction, the mucosal defect site was covered with mucosal epithelium in both groups. However, while squamous epithelium was mostly observed in the cartilage group, columnar epithelium containing the healthy ciliary and goblet cells was observed in the perichondrium group. Statistically significant differences were detected in the parameters of epithelial morphology between the two groups, which were higher in the perichondrium group. Conclusions In the reconstruction of mucosal defects using free mucosal grafts, difference in recipient tissue affects the graft epithelial morphology. Level of Evidence NA Laryngoscope, 132:2301–2306, 2022

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mucosal Epithelial Preservation of Free Nasal Grafts Depending on the Recipient Site

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“…Therefore, it is essential to release the bone in order to firmly release the cyst [7]. Previous reports have described the effective use of pedunculated mucoperiosteal flaps to prevent recurrence [3,4,5].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, reports from an animal study suggested that reconstruction with a pedicled flap had advantages, including preservation of the healthy mucosal epithelium and suppression of inflammation on the reconstruction site, as compared with free grafts [5].…”

Section: Introductionmentioning

confidence: 99%

A Covered Lateral and Posterior Wall Flap of the Maxillary Sinus Prevents Reocclusion of the Postoperative Maxillary Cyst

Aoki

Omura

Miyashita

et al. 2021

Indian J Otolaryngol Head Neck Surg

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Although the number of postoperative maxillary cyst (POMC) cases has declined recently, a few reports of refractory cases have also been reported. The indications for endoscopic sinus surgery (ESS) for POMC removal are broadening and attempts to prevent postoperative recurrence at the cyst opening site have been widely investigated. Here, we have advocated our original pedunculated mucoperiosteal flap (CLAP flap; covered lateral and posterior wall flap of the maxillary sinus), where the bony area exposed intraoperatively is covered, to prevent postoperative recurrence. We have also presented the method for creating the CLAP flap. We classified the POMC as being medial, lateral, or anterior superior type and performed ESS. We introduced the CLAP flap after 2015 for the lateral type and some of the medial types of POMCs. We examined the cyst opening rate using computed tomography, age, sex, cyst position, and a follow-up period in four patients (five sides) who did not undergo flap surgery, but who were managed in our hospital in 2015, and in eight patients (nine sides) who underwent the CLAP flap technique in our hospital. In the group with the CLAP flap, the cyst opening rate was significantly higher (P \ 0.05). The CLAP flap was effective for preventing postoperative bony regrowth. It may be one of the options for covering the exposed bone surface as widely as possible.

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Nasal Packing Materials and Placement Duration on Wound Healing in Nasal Mucosa: An Animal Study

et al. 2023

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ObjectiveThe histological findings of wound healing depending on different nasal packing materials and replacement periods were lacking.MethodsMucosal defects were created in the nasal septum of rabbits and covered with Spongel®, Algoderm®, or Nasopore®, which were cleaned on Day 14. To investigate the effect of replacement durations, Spongel® was removed on Days 3 and 7. All nasal septal specimens were collected on Day 28. Samples without packing material were prepared as controls. Depending on residual packing materials in the regenerated tissue, specimens were classified into the remnant and non‐remnant groups, and morphology was compared using epithelium grade score and subepithelial thickness.ResultsThe epithelium grade score in the Spongel‐14d group was lower than that in the other groups (p < 0.05). Subepithelial thickness was higher in the Algoderm‐14d and Spongel‐14d groups (p < 0.05). Epithelium grade scores were higher and subepithelial thicknesses were lower in the Spongel‐3d and ‐7d groups than in the Spongel‐14d group. Epithelium grade score was lower and subepithelial thickness was higher in the remnant group (n = 10) than in the non‐remnant group (n = 15; p < 0.05).ConclusionsDifferences in packing materials and placement durations affected wound healing of nasal mucosa. The selection of appropriate packing materials and replacement duration was considered essential for ideal wound healing.Level of EvidenceNA Laryngoscope, 2023

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Pathological Features of Free Graft and Pedicled Flap in the Nasal Cavity: An Animal Study

Cited by 8 publications

References 37 publications

Mucosal Epithelial Preservation of Free Nasal Grafts Depending on the Recipient Site

Mucosal Epithelial Preservation of Free Nasal Grafts Depending on the Recipient Site

A Covered Lateral and Posterior Wall Flap of the Maxillary Sinus Prevents Reocclusion of the Postoperative Maxillary Cyst

Nasal Packing Materials and Placement Duration on Wound Healing in Nasal Mucosa: An Animal Study

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