Repair of Nasal Septal Perforations Using Conjugate Polydioxanone Plate and Autologous Cartilage Interpositional Grafts

Hughes, Jonathan; Paun, Santdeep

doi:10.1177/0194599811424045

Cited by 16 publications

(25 citation statements)

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“…4 To improve results, surgeons started to add a graft that serves as a scaffold to the mucosal flaps. [5][6][7][8] Boenisch and Nolst Trenité 7 and Hughes and Paun 8 reported the use of polydioxanone (PDS) plates in combination with cartilage to be useful as an interposition graft for septal perforation and deformity repair. Hughes and Paun 8 were able to close several septal perforations but still used mucoperichondrial flaps to cover the graft.…”

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confidence: 99%

“…[5][6][7][8] Boenisch and Nolst Trenité 7 and Hughes and Paun 8 reported the use of polydioxanone (PDS) plates in combination with cartilage to be useful as an interposition graft for septal perforation and deformity repair. Hughes and Paun 8 were able to close several septal perforations but still used mucoperichondrial flaps to cover the graft. Flavill and Gilmore 9 recently provided evidence that the insertion of a graft alone via an open columellar approach without a flap could serve as a scaffold for the healing mucosa.…”

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Closure of Nasal Septal Perforations with a Polydioxanone Plate and Temporoparietal Fascia in a Closed Approach

Epprecht

Schlegel

Holzmann

et al. 2017

Am J Rhinol�Allergy

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confidence: 99%

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Closure of Nasal Septal Perforations with a Polydioxanone Plate and Temporoparietal Fascia in a Closed Approach

Epprecht

Schlegel

Holzmann

et al. 2017

Am J Rhinol�Allergy

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“…Polydioxanone has been used successfully in the repair of bony deficiencies 8,9 and in septal reconstruction procedures. [10][11][12][13][14][15][16][17] Studies examining the properties of PDS in bone repair have demonstrated that PDS is fully resorbed and does not interfere with the healing process. 9 These properties reduce the risk for potential long-term complications.…”

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Polydioxanone Absorbable Plate for Cartilaginous Grafting in Endonasal Rhinoplasty

Dayan

Ashourian

2016

JAMA Facial Plast Surg

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The caudal septal extension (CSE) graft maneuver commonly is used to adjust the nasal tip projection. It can, however, be difficult to stabilize and straighten the CSE graft, especially when the procedure is performed through an endonasal approach. Because the stabilization and correct positioning of the CSE graft are vital for achievement of the desired outcome, new approaches must be found that facilitate the technical ease of this procedure. OBJECTIVE To assess the safety and efficacy of the polydioxanone (PDS) absorbable plate in CSE graft procedures performed via an endonasal approach. DESIGN, SETTING, AND PARTICIPANTS In an open-label, 2-arm parallel trial, 30 patients who requested a surgical nasal correction and required a CSE graft performed via an endonasal approach were randomized into 2 groups of 15 patients each. All patients underwent endonasal rhinoplasty at a single center from February 17, 2011, to December 26, 2013. Depending on their treatment group, patients received a CSE graft with or without a PDS plate. Data were collected and evaluated from November 24, 2010, to January 19, 2015, when final follow-up occurred. Data were analyzed based on an evaluable population. INTERVENTIONS Endonasal rhinoplasty with or without the use of a PDS plate. MAIN OUTCOMES AND MEASURES Technical difficulty assessed using a visual analog scale (range, 0-100; higher scores indicate increased difficulty of use), surgeon and blinded evaluator satisfaction with the graft assessed using a 4-point categorical scale (1 indicates highly satisfied; 4, unsatisfied), change in nasal tip projection, and complications at 30, 60, 180, and 365 days after surgery. RESULTS Twenty-seven patients (13 in the PDS group and 14 in the non-PDS group) completed their 6-month postoperative visit, and 19 patients (10 in the PDS group and 9 in the non-PDS group) completed the entire study (12 months). The mean (SD; range) surgeon-assessed visual analog scale score for ease of use was 46 (13; 25-64) mm for the 15 patients in the non-PDS treatment group and 17 (10; 7-48) mm for the 15 patients in the PDS group (P < .001). The surgeon's satisfaction with the graft did not differ significantly between the PDS and the non-PDS groups (P = .34), and the nontreating blinded evaluator's assessment of standardized photographs taken at the time of the graft placement and at postoperative days 30, 60, 180, and 365 did not establish any significant differences between the 2 groups (P > .99). Postoperative change in the nasal tip projection at 365 postoperative days compared with 30 postoperative days was significantly lower in the PDS group compared with the non-PDS group (−0.31% vs −6.5%; P = .04), thus increasing the long-term stability of the graft in the PDS group. A single incident of infection was observed in each group along with no episodes of rejection or extrusion. CONCLUSIONS AND RELEVANCE In this study, use of a PDS plate in CSE graft procedures was associated with less technical difficulty than CSE graft procedures without use of a PDS pla...

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“…18 While in other studies the frequency of perforation ranges from 3-25%. 19 The exact frequency is very difficult to determine as long term studies and clear differentiation of the severity or classification of septum perforations are lacking. The septal hematoma was found in 2(4%) patients of submucous resection group while in septoplasty patients no complications observed.…”

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confidence: 99%

Complications of Submucous Resection versus Septoplasty in Deviated Nasal Septum

Khan¹,

Chaudhry²,

Arif³

et al. 2020

JRMC

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Introduction: A deviated or deflected septum is a condition in which the nasal septum consisting of bone and cartilage and that divide the nasal cavity into two halves is significantly off-center, or twisted, making breathing difficult. Two conventional methods that are septoplasty and sub-mucous resection were used for the correction of the deviated nasal septum with varying degrees of complications. Objective: The objective of this study was to compare the complications of sub-mucous resection and septoplasty in patients with the deviated nasal septum. Material and Methods: A Quasi-experimental study was conducted at the Department of Otolaryngology at Bolan Medical Complex, Quetta for a period of one year i.e. from 15-03-2015 to 20-09-2015. 100 patients were selected and divided into two groups. A total of 50 patients were selected for septoplasty and 50 for sub-mucous resection. Patients with nasal bone fracture and external nasal deformity were excluded from the study. Results: Postoperative complications like adhesions were found in 4 cases of each group. Septal perforation found in 3 patients of sub-mucous resection and one patient of septoplasty. Septal hematoma formed in 2 patients of sub-mucous resection only, supra-tip nasal deformity in 2 patients in both groups. Persistence of symptoms in 8 patients of septoplasty and one patient of sub-mucous resection while columellar restriction occurred in only one patent who underwent submucous resection. Conclusion: Sub-mucous resection procedure is technically relatively easy to perform with fewer complications than septoplasty so it deserves it prime role as a surgical procedure for nasal septum corrective surgery. Keywords: Deviated nasal septum, nasal septum corrective surgery, sub-mucous resection, septoplasty

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Repair of Nasal Septal Perforations Using Conjugate Polydioxanone Plate and Autologous Cartilage Interpositional Grafts

Cited by 16 publications

References 6 publications

Closure of Nasal Septal Perforations with a Polydioxanone Plate and Temporoparietal Fascia in a Closed Approach

Closure of Nasal Septal Perforations with a Polydioxanone Plate and Temporoparietal Fascia in a Closed Approach

Polydioxanone Absorbable Plate for Cartilaginous Grafting in Endonasal Rhinoplasty

Complications of Submucous Resection versus Septoplasty in Deviated Nasal Septum

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