Surgical repair of nasal septal perforations

McLaughlin, Eamon J.; Friedman, Oren

doi:10.1097/moo.0000000000000224

Cited by 13 publications

(17 citation statements)

References 29 publications

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“…A contemporary review on the surgical repair of nasal septal perforations (NSPs) argued that the diversity of available techniques is because clinicians remain dissatisfied with clinical outcomes and are constantly modifying techniques to improve ultimate surgical results. 1 This was compounded by the lack of comparative data, and it was impossible to determine the true effectiveness of each technique due to the small study cohorts, heterogeneous aetiology and short follow-up period. 2 Qualitative measures of patients' symptoms and a disease-specific tool were also identified as quintessential to improving the quality of clinical studies on NSPs.…”

Section: Introductionmentioning

confidence: 99%

Sino‐Nasal Outcome Test‐22 quality‐of‐life patterns in patients presenting with nasal septal perforation

Leong

Webb

2017

Clinical Otolaryngology

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Section: Introductionmentioning

confidence: 99%

Sino‐Nasal Outcome Test‐22 quality‐of‐life patterns in patients presenting with nasal septal perforation

Leong

Webb

2017

Clinical Otolaryngology

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“…A review published in 2016 updated closure outcomes in perforation surgery. 7 Techniques and their variants were grouped into multilayer closures (14 studies), single-layer mucosal flap closure (4 studies), and free patch (scaffolding graft) procedures (8 studies) to facilitate analysis. Unilateral flap and free scaffold graft procedures attempt to decrease the technical difficulty attributed to bilateral flap procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Addition of an interposition graft to mucosal flap repairs improved success rates, but the results did not achieve statistical significance. A review published in 2016 updated closure outcomes in perforation surgery 7 . Techniques and their variants were grouped into multilayer closures (14 studies), single‐layer mucosal flap closure (4 studies), and free patch (scaffolding graft) procedures (8 studies) to facilitate analysis.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Septal Perforation Repair With Concurrent Endoscopic Sinus Surgery

Abdel-Aty

Cain²,

Taylor

et al. 2021

Otolaryngol.--head neck surg.

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Objective This study reviews a cohort of patients in whom septal perforation repair was performed concurrently with endoscopic sinus surgery. We present an endonasal perforation repair technique using bilateral mucosal flaps with an autogenous interposition graft. Intraoperative and postoperative management of the combined surgical patient is discussed and perforation closure outcomes are reported. Study Design Case series. Setting Tertiary care center. Methods In this institutional review board–approved retrospective chart review, adult patients who underwent concurrent bilateral mucosal flap septal perforation repair and endoscopic sinus surgery from March 1992 to March 2020 were identified. Data on demographics, clinical presentations, perforation size, surgical techniques, and outcomes were extracted and analyzed for patients with a minimum of 3 months of follow-up. Results Fifty-six patients met study inclusion criteria. Nasal obstruction/congestion was the most frequent symptom reported (80.4%), followed by crusting and epistaxis. Mean perforation size measured at the time of surgery was 14.7 (range, 3-41) mm in length by 9.3 (range, 2-23) mm in height. Temporalis fascia was the most frequent (57.9%) interposition graft material used. Complete perforation closure at the time of the last follow-up was noted in 51 (91.1%) patients. Only 1 failure was noted in the last 48 attempted repairs. Conclusion Patients with a perforated septum may have coexistent chronic sinusitis. The feasibility of attempting concurrent sinus surgery and perforation repair has been questioned. Our review demonstrates a high perforation closure rate when a bilateral mucosal flap procedure is performed after sinus surgery is performed at the same setting.

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“…An updated review of published reports over the subsequent 4 years showed similar pooled success rates for multilayer (using an interposition graft), single layer mucosal flap, and patch "scaffolding" graft techniques. 9 Both reviews noted the inconsistent reporting of perforation size and the need for a validated perforation symptom instrument for the comparison of closure techniques.…”

Section: Discussionmentioning

confidence: 99%

Auricular Perichondrium Graft for Septal Perforation Repair

Bansberg

Taylor

Neel

2021

Ann Otol Rhinol Laryngol

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Objectives: Procedures which utilize bilateral mucosal flaps with an interposition graft are frequently used when attempting closure of a septal perforation. Concurrent surgical management of the nasal valve or an aesthetic deformity may be indicated. The objective of this study is to report our experience using auricular perichondrium for the interposition graft when auricular cartilage is harvested for structural or aesthetic graft material. Methods: A retrospective medical record review was performed for septal perforation repairs performed at Mayo Clinic in Arizona from January 2010 through January 2020. Patients identified for this study underwent a procedure utilizing bilateral nasal mucosal flaps with an auricular perichondrium interposition graft. Results: Forty-four patients (31 females) with a mean age of 53.3 years met study criteria. The most common presenting symptoms were nasal obstruction, crusting, and epistaxis. Prior septal surgery was the most common perforation etiology (45.5%). Mean perforation length was 11.8 (range, 3-26) mm and height, 9.1 (range, 2-16) mm. Auricular cartilage was harvested for nasal valve surgery in 43 patients. Complete perforation closure was noted in 95.3% (41/43) of patients with a minimum post-operative follow-up of 3 (mean, 20.4) months. Four patients underwent revision surgery for persistent postoperative nasal obstruction. Conclusion: The ear can provide both cartilage and perichondrium for use in septal perforation surgery. Our study demonstrates the successful use of auricular perichondrium as the interposition graft for a perforation closure procedure utilizing bilateral nasal mucosal flaps.

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Surgical repair of nasal septal perforations

Cited by 13 publications

References 29 publications

Sino‐Nasal Outcome Test‐22 quality‐of‐life patterns in patients presenting with nasal septal perforation

Sino‐Nasal Outcome Test‐22 quality‐of‐life patterns in patients presenting with nasal septal perforation

Outcomes of Septal Perforation Repair With Concurrent Endoscopic Sinus Surgery

Auricular Perichondrium Graft for Septal Perforation Repair

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