Pediatric Septal Perforation Repair With the Endoscopic Anterior Ethmoid Artery Flap

2020 ◽  
pp. 019459982094221
Author(s):  
Samih J. Nassif ◽  
Andrew R. Scott
Keyword(s):  
Open Repair ◽  
Early Adulthood ◽  
Initial Experience ◽  
Septal Perforation ◽  
Septal Defects ◽  
Nasal Septal Perforation ◽  
Recurrent Epistaxis ◽  
Septal Perforations ◽  
Established Technique ◽  
Anterior Ethmoid Artery

Pediatric nasal septal perforations can lead to crusting, obstruction, whistling, and recurrent epistaxis. Current approaches for pediatric nasal septal repair center on combination endonasal and external approaches. Herein we describe the successful utilization of a purely endoscopic anterior ethmoid artery flap, an established technique in adults, for nasal septal perforation repair in 3 children aged 12 to 13 years who presented with septal perforations ranging in size from 6 to 12 mm. Successful closure was achieved with an endoscopic anterior ethmoid artery flap, with all patients achieving complete closure and symptom resolution. Children with nasal septal defects are typically treated with temporizing measures until early adulthood, when definitive open repair may be performed. Our initial experience with the anterior ethmoid artery flap technique suggests that this surgery may be easily performed in children as young as 12 years, without the use of previously described adjunctive procedures such as turbinate translocation.

Repair of nasal septal perforation using inferior turbinate graft

2011 ◽  
Vol 125 (5) ◽  
pp. 474-478 ◽  
Author(s):  
Hesham A K A Mansour
Keyword(s):  
Surgical Repair ◽  
Inferior Turbinate ◽  
Septal Perforation ◽  
Free Graft ◽  
Endoscopic Repair ◽  
Endoscopic Endonasal ◽  
Nasal Septal Perforation ◽  
Recurrent Epistaxis ◽  
Septal Perforations

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.

Asymptomatic Nasal Septal Perforations in Systemic Lupus Erythematosus

1980 ◽  
Vol 89 (1) ◽  
pp. 78-80 ◽  
Author(s):  
David Reiter ◽  
Allen R. Myers
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Common Phenomenon ◽  
Septal Perforation ◽  
Systemic Lupus ◽  
Clinical Correlates ◽  
Nasal Septal Perforation ◽  
Diagnostic Criterion ◽  
Septal Perforations

Nasal septal perforation has been considered a diagnostic criterion for systemic lupus erythematosus since 1971. However, little has been published in the otorhinolaryngologic literature regarding this lesion. We report six patients having asymptomatic anteroinferior nasal septal perforations and symptomatic lupus. No obvious clinical correlates were found. We support the hypothesis that nasal septal perforation in systemic lupus erythematosus is a common phenomenon, and attribute its infrequent detection to the asymptomatic nature of the lesion in this setting.

Repair of Nasal Septal Perforation

1997 ◽  
Vol 11 (1) ◽  
pp. 35-40 ◽  
Author(s):  
Mohammed Yousef-Mian
Keyword(s):  
Success Rate ◽  
Double Layer ◽  
The Other ◽  
Septal Perforation ◽  
Current Analysis ◽  
Operative Techniques ◽  
Nasal Septal Perforation ◽  
Novel Method ◽  
Incomplete Closure ◽  
Septal Perforations

The management of nasal septal perforation remains unsatisfactory. Various operative techniques have been described, with modest success. A novel method for repair of septal perforations up to 2.6 cm in diameter was investigated. A double layer closure of nasal septal perforation was designed, one with the cartilage and the other by a flap based on the anterior septal branches of the sphenopalatine artery. Fourteen patients have been operated upon. The current analysis reveals a success rate of 13 patients (93%) who had complete closure and one patient (7%) with incomplete closure. The operative techniques and results are reported here.

Large Septal Perforation Repair Using Inferior Turbinate Sliding Advancement Flap

1989 ◽  
Vol 3 (4) ◽  
pp. 185-189 ◽  
Author(s):  
Francis A. Papay ◽  
Isaac Eliachar ◽  
Robert Risica ◽  
Marion Carroll
Keyword(s):  
Case Report ◽  
Surgical Technique ◽  
Nasal Mucosa ◽  
Inferior Turbinate ◽  
Advancement Flap ◽  
Illustrative Case ◽  
Septal Perforation ◽  
Septal Defects ◽  
Septal Perforations

A surgical technique for closure of septal perforations is described, along with an illustrative case report. The technique consists of a posterolaterally based sliding advancement flap of the nasal mucosa covering the inferior turbinate, inferolateral nasal wall, and floor of nose. It has proven effective in closure of several large septal defects as illustrated in the case report.

Nasal Septal Perforation and Carotid Cavernous Aneurysm: Unusual Manifestations of Systemic Lupus Erythematosus

1996 ◽  
Vol 115 (1) ◽  
pp. 163-166 ◽  
Author(s):  
Don N. Lerner
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Central Nervous System ◽  
Nervous System ◽  
Lupus Erythematosus ◽  
Septal Perforation ◽  
Vascular Disorder ◽  
Cell Nuclei ◽  
Systemic Lupus ◽  
Nasal Septal Perforation ◽  
Septal Perforations

Systemic lupus erythematosus (SLE) is a multisystem collagen vascular disorder defined by its clinical features and the presence of antibodies in the blood directed against one or more cell nuclei components. Typically, SLE affects the head and neck in the form of cutaneous malar erythema and oropharyngeal mucosal ulcerations. The uncommon findings of nasal septal perforations and restrictive central nervous system (CNS) aneurysmal formation as initial manifestations of SLE are detailed in this case report.

Modified tragal cartilage – temporoparietal and deep temporal fascia sandwich graft technique for repair of nasal septal perforations

1997 ◽  
Vol 111 (5) ◽  
pp. 435-437 ◽  
Author(s):  
A. Hussain ◽  
P. Murthy
Keyword(s):  
Operative Technique ◽  
Observation Time ◽  
Septal Perforation ◽  
Sandwich Technique ◽  
Temporal Fascia ◽  
Nasal Septal Perforation ◽  
Septal Perforations

AbstractFifteen cases of nasal septal perforation were repaired with a tragal cartilage–temporoparietal and deep temporal fascia sandwich technique using a modification of the approach previously described (Hussain and Kay, 1992). Successful closure was achieved in 14 patients (100 per cent) after an observation time of up to two years. The operative technique and advantages of the modified approach are described.

Porcine Tracheal Mucosa-Derived Decellularized Patch to Prevent Septal Perforation in a Rabbit Model

2020 ◽  
pp. 194589242096197
Author(s):  
So Jeong Kim ◽  
Soo Yeon Jung ◽  
Min Ji Lee ◽  
Jung Ho Bae ◽  
Han Su Kim
Keyword(s):  
Rabbit Model ◽  
Cartilage Regeneration ◽  
Control Group ◽  
Septal Perforation ◽  
Tracheal Mucosa ◽  
Mucosal Regeneration ◽  
Nasal Cartilage ◽  
Bilateral Group ◽  
Nasal Septal Perforation ◽  
Septal Perforations

Background Nasal septal perforation is caused by bilateral septal mucosal injuries resulting from nasal trauma and septal surgeries. Previous studies have reported that biocompatible materials may be effective for repairing nasal septal perforations. However, they were primarily used for treatment; no study has investigated their use for prevention of nasal septal perforation. Objective To determine whether porcine tracheal mucosa-derived decellularized patch can prevent the progression of nasal mucosa injuries to septal perforations. Methods Bilateral nasal septal mucosal defects were surgically induced in 36 rabbits. Silastic sheets were applied bilaterally in all rabbits, and decellularized mucosal patch was applied unilaterally (n = 12) or bilaterally (n = 12) at the defect site in the respective experimental groups. Between 1 and 8 weeks postoperatively, the animals were sacrificed, and their nasal septa were completely removed. The excised septa were examined macroscopically and microscopically (histopathological examinations). Moreover, glycosaminoglycan (GAG) estimations of the septa were performed to evaluate mucosal regeneration and mechanical properties. Results Septal perforations occurred in 5 animals in the control group (5/12; 42%), 1 in the unilateral group (1/12; 9%), and in none in the bilateral group. Compared with the control group, the experimental groups showed significantly different mucosal and cartilage regeneration. Conclusion Decellularized porcine tracheal mucosa can prevent mucosal defects from progressing to septal perforation, promote the repair of mucosal defects, and protect the nasal cartilage.

Tragal cartilage inferior turbinate mucoperiosteal sandwich graft technique for repair of nasal septal perforations

1992 ◽  
Vol 106 (10) ◽  
pp. 893-895 ◽  
Author(s):  
A. Hussain ◽  
N. Kay
Keyword(s):  
Success Rate ◽  
Inferior Turbinate ◽  
Septal Perforation ◽  
Nasal Septal Perforation ◽  
Septal Perforations

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.

Effects of septal perforation on nasal airflow: computer simulation study

2009 ◽  
Vol 124 (1) ◽  
pp. 48-54 ◽  
Author(s):  
H P Lee ◽  
R R Garlapati ◽  
V F H Chong ◽  
D Y Wang
Keyword(s):  
Computer Simulation ◽  
Flow Rate ◽  
Cross Flow ◽  
Computer Simulation Model ◽  
Nasal Airflow ◽  
Septal Perforation ◽  
Lower Flow ◽  
Nasal Septal Perforation ◽  
Septal Perforations ◽  
Lower Flow Rate

AbstractBackground:Nasal septal perforation is a structural or anatomical defect in the septum. The present study focused on the effects of septal perforation on nasal airflow and nasal patency, investigated using a computer simulation model.Methods:The effect of nasal septal perforation size on nasal airflow pattern was analysed using computer-generated, three-dimensional nasal models reconstructed using data from magnetic resonance imaging scans of a healthy human subject. Computer-based simulations using computational fluid dynamics were then conducted to determine nasal airflow patterns.Results:The maximum velocity and wall shear stress were found always to occur in the downstream region of the septal perforation, and could potentially cause bleeding in that region, as previously reported. During the breathing process, there was flow exchange and flow reversal through the septal perforation, from the higher flow rate to the lower flow rate nostril side, especially for moderate and larger sized perforations.Conclusion:In the breathing process of patients with septal perforations, there is airflow exchange from the higher flow rate to the lower flow rate nostril side, especially for moderate and large sized perforations. For relatively small septal perforations, the amount of cross-flow is negligible. This cross-flow may cause the whistling sound typically experienced by patients.

Nasal Septal Perforation Closure by “Sandwich Grafts”: Technique, Initial Results

2021 ◽  
Author(s):  
Mattis Bertlich ◽  
Friedrich Ihler ◽  
Maya Bertlich ◽  
Mark Jakob ◽  
Martin Canis ◽  
...  
Keyword(s):  
Nasal Septum ◽  
Case Series ◽  
Septal Perforation ◽  
Auricular Cartilage ◽  
Reliable Technique ◽  
Temporal Fascia ◽  
Nasal Septal Perforation ◽  
Foreign Materials ◽  
Septal Perforations ◽  
Initial Results

AbstractNasal septal perforation closure represents a considerable surgical challenge. Many techniques rely on the implantation of foreign materials that pose a persisting threat of infection. The authors have identified a reliable technique closing septal perforations by an autologous “sandwich graft.” It is layered around a piece of auricular cartilage, covered with temporal fascia, thus emulating the physiological layers of the nasal septum. Finally, the prepared graft is then sewn into the perforation in an underlay technique and kept in place by septal splints for 4 weeks. The technique is easily feasible and strives to reconstruct the nasal as physiological as possible. The data obtained from a case series of 11 patients highlights the efficacy of the technique.

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