Septal Perfoplasty for Management of Symptomatic Nasal Septal Perforation: An Alternative to Surgical Closure

Davis, Seth J.; Morse, Justin C.; Kimura, Kyle S.; Dedhia, Raj; Bauer, Ashley M.; Beckler, Andrew D.; Wright, Harry V.; Russell, Paul T.; Stephan, Scott J.

doi:10.1089/fpsam.2020.0155

Cited by 9 publications

(7 citation statements)

References 27 publications

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“…35 A retrospective review of 20 patients undergoing perfoplasty technique demonstrated "favorable" perforation characteristics postoperatively in 95% of patients and 90% with acceptable symptomatic control. 11 It should be cautioned, that patient selection is the key with this particular technique, with the authors noting that all patients in this study had "unfavorable" perforations preoperatively and the decision to proceed to the operating room was based on patient symptomatology (►Fig. 3).…”

Section: Perfoplastymentioning

confidence: 97%

“…9,10 The quality of the perforation, which can be described as "favorable" with clean mucosal edges or "unfavorable" with exposed bone or cartilage with crusting, may also determine whether a NSP is symptomatic or asymptomatic. 11 Larger perforations, i.e. those greater than 2cm, have not been found necessarily to correlate with increased symptoms, however increased perforation size does play a role in whether surgical repair is successful or not.…”

Section: Etiologymentioning

confidence: 99%

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Repair of Septal Perforations

2022

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Section: Perfoplastymentioning

confidence: 97%

Section: Etiologymentioning

confidence: 99%

Repair of Septal Perforations

2022

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“…In combination with an aggressive nasal hygiene regimen, perfoplasty can reduce symptoms without a formal repair. 3 Creating a healthy perforation microenvironment not only reduces symptoms but also increases the probability of successful definitive surgery (►Fig. 1).…”

Section: Perforation Considerationsmentioning

confidence: 99%

Rhinoplasty with Concurrent Repair of Septal Perforation

Jones,

Olson

2023

Facial Plast Surg

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Concurrently performing septal perforation repair and rhinoplasty is challenging. Successful management of patients who require or desire these procedures performed simultaneously can be achieved with appropriate preoperative workup and optimization, thoughtful surgical planning, masterful execution, and diligent postoperative care. Consideration of perforation etiology and status of the perforation along with overall nasal health are the foundation upon which surgery may be planned. Preoperative evaluation to determine locations of obstruction, aesthetic goals, and feasibility of procedure is required. Rhinoplasty techniques and perforation closure techniques may share common maneuvers making concurrent surgery possible. Surgical techniques to achieve perforation closure often influence rhinoplasty considerations, and vice versa. Care must be taken to account and possibly even to capitalize on these influences. Perforation closure techniques that may be readily combined with rhinoplasty include interposition grafting and intranasal mucosal rotational advancement flaps, which may exert forces upon the nose with aesthetic or functional consequences. Rhinoplasty techniques targeting any third of the nose also can impact tension or available mucosa for perforation closure techniques. Combining these procedures can be very rewarding for the patient and provider but should be considered responsibly and thoughtfully.

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“…Closure success rates exceeding 90% are frequently reported using these varied procedures 1–8 . For perforations not amendable to attempted closure, the endoscopic skull base surgery experience has provided insight to support surgical modification of the posterior perforation margin for symptom relief 9,10 . Customized silastic prostheses may improve fit and tolerance over standard septal buttons 11–13 .…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8] For perforations not amendable to attempted closure, the endoscopic skull base surgery experience has provided insight to support surgical modification of the posterior perforation margin for symptom relief. 9,10 Customized silastic prostheses may improve fit and tolerance over standard septal buttons. [11][12][13] Pre-treatment evaluation and objective measurement of presenting symptomatology have not been standardized.…”

Section: Introductionmentioning

confidence: 99%

Presenting Symptomatology for Patients With Nasal Septal Perforation: Application of the NOSE‐Perf Scale

2022

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Objective To objectively identify and quantitate presenting nasal symptoms in patients with a septal perforation using the validated NOSE‐Perf scale. Study Design Case series retrospective review. Methods The medical records from August 2018 through January 2022 of patients at a tertiary care academic center with a septal perforation, and who completed the NOSE‐Perf questionnaire, were reviewed. Perforation symptoms were identified and quantified using the 12‐item NOSE‐Perf scale (score range 0–48). NOSE‐Perf findings were correlated to patient demographics, perforation etiology, and perforation length. NOSE‐Perf scores of patients who pursued treatment were compared with those who did not. Results NOSE‐Perf data were collected from 202 patients. Nasal crusting was noted in 94.1% of patients and was the most severe symptom reported (mean 2.9 of 4.0). Nasal congestion, difficulty breathing, and nasal obstruction followed in prevalence and severity. The mean total NOSE‐Perf score was 23.7. Linear regression analysis demonstrated a weakly negative association of NOSE‐Perf score with patient age and weakly positive association with increasing perforation length. NOSE‐Perf scores were significantly higher in women and in patients pursuing treatment. Conclusion This is the first study to use the validated NOSE‐Perf scale to objectively characterize and establish baseline septal perforation symptomatology. The NOSE‐Perf scale can play a role in the standardization of perforation evaluation and treatment outcomes assessment. Laryngoscope, 133:1315–1320, 2023

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Septal Perfoplasty for Management of Symptomatic Nasal Septal Perforation: An Alternative to Surgical Closure

Cited by 9 publications

References 27 publications

Repair of Septal Perforations

Repair of Septal Perforations

Rhinoplasty with Concurrent Repair of Septal Perforation

Presenting Symptomatology for Patients With Nasal Septal Perforation: Application of the NOSE‐Perf Scale

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