The results of septal button insertion in the management of nasal septal perforation

1999 ◽  
Vol 113 (9) ◽  
pp. 823-824 ◽  
Author(s):  
Üstün Osma ◽  
Sebahattin Cüreoǧlu ◽  
Nursel Akbulut ◽  
Faruk Meriç ◽  
Ismail Topçu

AbstractNasal septal perforation may present with various symptoms. Perforations may be surgically closed or managed by obturation, inserting a prosthesis. We used a silicon septal button in the management of nasal septal perforation. In the follow-up period, although the insertion of the nasal septal button alleviated epistaxis, whistling during inspiration, and nasal obstruction, it could not control the production of crusting around the margin of the button.

2021 ◽  
pp. 019459982199201
Author(s):  
Cullen M. Taylor ◽  
Stephen F. Bansberg ◽  
Michael J. Marino

Objective Reporting patient symptoms due to nasal septal perforation (NSP) has been hindered by the lack of a validated disease-specific symptom score. The purpose of this study was to develop and validate an instrument for assessing patient-reported symptoms related to NSP. Study Design Validation study. Setting A tertiary care center. Methods The Nasal Obstruction Symptom Evaluation (NOSE) scale was used as an initial construct to which 7 nonobstruction questions were added to measure septal perforation symptoms. The proposed NOSE-Perf instrument was distributed to consecutive patients evaluated for NSP, those with nasal obstruction without NSP, and a control group without rhinologic complaints. Questionnaires were redistributed to the subgroup with NSP prior to treatment of the perforation. Results The study instrument was completed by 31 patients with NSP, 17 with only nasal obstruction, and 22 without rhinologic complaint. Internal consistency was high throughout the entire instrument (Cronbach α = 0.935; 95% CI, 0.905-0.954). Test-retest reliability was demonstrated by very strong correlation between questionnaires completed by the same patient at least 1 week apart ( r = 0.898, P < .001). Discriminant validity was confirmed via a receiver operating characteristic ( P < .001, area under the curve = 0.700). The NOSE-Perf scale was able to distinguish among all 3 study groups ( P < .001) and between NSP and nasal obstruction ( P = .024). When used alone, the NOSE scale could not discriminate between NSP and nasal obstruction ( P = .545). Conclusions The NOSE-Perf scale is a validated and reliable clinical assessment tool that can be applied to adult patients with NSP.


2015 ◽  
Vol 8 ◽  
pp. CMENT.S23230 ◽  
Author(s):  
Paula Virkkula ◽  
Antti a. Mäkitie ◽  
Seija i. Vento

Aims Surgical treatment of nasal septal perforation remains a challenging field of rhinology. A large variety of techniques and grafts with promising results have been introduced for perforation repair. However, the use of fascia or fascia with periosteum has not been previously evaluated for a large sample of patients. Methods During the years 2007–2014, 105 operations were performed and 98 patients were treated for nasal septal perforation at the Department of Otorhinolaryngology–-Head and Neck Surgery, Helsinki University Hospital, Helsinki, Finland. We performed a retrospective review of closure rates and complications. Follow-up time ranged from 1 to 62 months. Results Bleeding was the most common early complication (9%), followed by postoperative infection (5%) in the whole series. Our main technique, bipedicled advancement flaps with fascia or fascia and periosteum, was performed for 81 patients. We obtained successful closure in 78% of these patients with this operative technique and the rate increased to 86% during the last 3 years of the study period. Conclusions Perforation repair with temporal fascia or fascia with periosteum requiring only one donor site seems to be a reliable option for nasal septal perforation repair.


1992 ◽  
Vol 106 (10) ◽  
pp. 893-895 ◽  
Author(s):  
A. Hussain ◽  
N. Kay

AbstractTen cases of large nasal septal perforation were repaired with a tragal cartilage inferior turbinate mucoperiosteal sandwich graft technique with 70 per cent success rate over a follow-up period of up to 24 months. The technique is described in detail. The results are comparable to other techniques.


2021 ◽  
pp. 000348942110157
Author(s):  
Stephen F. Bansberg ◽  
Cullen M. Taylor ◽  
Gregory S. Neel

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.


2011 ◽  
Vol 125 (5) ◽  
pp. 474-478 ◽  
Author(s):  
Hesham A K A Mansour

AbstractObjective:Nasal septal perforation can cause troublesome symptoms. Surgical repair is indicated in symptomatic patients. Many approaches and techniques have been described, each with its advantages and indications.Method:The study included six patients with symptomatic nasal septal perforations sized 1–2.5 cm horizontally by 0.5–1.5 vertically. Patient symptoms included nasal crusts (all patients), nasal obstruction (five), cacosmia (three) and recurrent epistaxis (three). Patients underwent endonasal endoscopic repair using an inferior turbinate free graft applied between the mucoperichondrium of both septum sides. Follow up ranged from six months to two years.Results:Five patients (83 per cent) had complete perforation closure and one had partial closure. All patients were symptom-free post-operatively.Conclusion:This endoscopic endonasal approach, using an inferior turbinate free graft, is effective in closing small and medium-sized nasal septal perforations.


Author(s):  
Douglas M. Sidle ◽  
Pablo Stolovitzky ◽  
Ellen M. O'Malley ◽  
Randall A. Ow ◽  
Nathan E. Nachlas ◽  
...  

AbstractThe aim of the study is to report outcomes after treatment of nasal valve collapse with a bioabsorbable nasal implant. It involves two prospective, multicenter, post-market studies evaluating long-term effectiveness of the LATERA implant for severe to extreme nasal obstruction. Participants underwent implant alone or with concomitant inferior turbinate reduction (ITR) and/or septoplasty. Outcome measures included the change from baseline Nasal Obstruction Symptom Evaluation (NOSE) scores, NOSE responder rates, visual analog scale (VAS) scores, and adverse events. A total cohort of 277 participants (109 implants only, 67 implants + ITR, 101 implants + septoplasty + ITR) enrolled at 19 U.S. centers was available for analysis with 177 participants (69 implants only, 39 implants + ITR, 69 implants + septoplasty + ITR) available at 2 years. The mean changes from baseline in NOSE scores and VAS scores were statistically significant (p < 0.001) at all follow-up periods. The baseline NOSE score of 77.8 ± 13.6 was improved to 24.2 ± 23.6 at 24 months. Greater than 90% of participants were NOSE responders across all follow-up periods, 6.1% withdrew for lack of treatment effect. The baseline VAS score of 66.7 ± 18.8 was improved to 21.1 ± 23.9 at 24 months. There were no serious adverse events related to the device or implant procedure. Implant retrieval rate was 4.0% (22/543 implants). Nonserious adverse events were mild to moderate in severity, typically occurred within 6 months of implant, and resolved or were stable. Significant reductions in NOSE and VAS scores and high responder rates from our large population of patients with nasal obstruction who had nasal valve implants confirm sustained effectiveness at 24 months after treatment. The studies are registered on www.clinicaltrials.gov (NCT02952313 and NCT02964312).


2021 ◽  
pp. 014556132110015
Author(s):  
Filippo Ricciardiello ◽  
Davide Pisani ◽  
Pasquale Viola ◽  
Raul Pellini ◽  
Giuseppe Russo ◽  
...  

Objective: The aim of this study was to assess the long-term effectiveness of quantic molecular resonance (QMR) in the treatment of inferior turbinate hypertrophy (ITH) in allergic and nonallergic rhinitis refractory to medical therapy. Methods: This study enrolled 281 patients, 160 males (56.9%) and 121 females (43.1%), mean age 37.8 ± 4.1 years, range 18 to 71. Fifty-four patients have been lost to follow up and have been therefore excluded from the final analysis. Based on skin prick test results, 69 patients were considered allergic (group A) and 158 nonallergic (group B). All subjects underwent before surgery (T0) and 3 (T1), 12 (T2), 24 (T3), and 36 months (T4) after QMR treatment to: 4-phase rhinomanometric examination, nasal endoscopy evaluation, and visual analogue scale to quantify the subjective feelings about nasal obstruction. Results: Subjective and objective parameters showed statistically significant improvement in both groups. Group B parameters not changed during follow-up, while group A showed significant worsening between T1 and subsequent assessments. T4 outcome indicates a better result in nonallergic patients. Conclusions: In accordance with the literature, our preliminary data validate QMR treatment as a successful therapeutic option for nasal obstruction due to ITH. Nonallergic patients had a very good T4 outcome. Allergic patients showed a worsening trend after 1 year probably due to other causes.


2021 ◽  
Vol 8 (30) ◽  
pp. 2778-2783
Author(s):  
Nikhila Rajendran ◽  
Jaya C ◽  
Venugopal M ◽  
Satheesh S

BACKGROUND Nasal obstruction secondary to inferior turbinate hypertrophy significantly affects the quality of life. Patients refractory to medical treatment are taken up for surgery. Laser turbinate reduction is an effective and simple method for treatment of nasal obstruction due to inferior turbinate hypertrophy. Only a few studies reported on the outcome of laser inferior turbinate reduction in India. The present study was done to assess the clinical outcome of laser inferior turbinate reduction in patients with nasal obstruction due to inferior turbinate hypertrophy. METHODS This prospective observational study was done in 31 patients (18 – 60 years) with nasal obstruction due to inferior turbinate hypertrophy refractory to medical management who underwent laser inferior turbinate reduction in ENT Department, Government Medical College, Thiruvananthapuram from December 2017 to September 2019. RESULTS All patients had bilateral inferior turbinate hypertrophy. 21 out of 31 patients had allergic rhinitis and rest had non-allergic rhinitis. Pre-operatively most patients had symptom score between 15 and 20. After CO2 laser inferior turbinate reduction at the end of 3 months of follow up, subjective assessment by symptom scoring confirmed by objective assessment by flowmetry 29 out of 31 patients had good outcome with relief from nasal obstruction. The success rate was more in nonallergic rhinitis (100 %) than the allergic rhinitis group (90.47 %). CONCLUSIONS CO2 laser inferior turbinate reduction is an effective procedure to relieve nasal obstruction in patients with inferior turbinate hypertrophy refractory to medical treatment, with minimal complications. Post-procedure on follow up significant number of patients had relief from hyposmia, sneezing and running nose. KEYWORDS Nasal Obstruction, Peak Nasal Inspiratory Flowmetry, Symptom Scoring, CO2 Laser, Outcome


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