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

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.

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.


1980 ◽  
Vol 89 (1) ◽  
pp. 78-80 ◽  
Author(s):  
David Reiter ◽  
Allen R. Myers

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.


1997 ◽  
Vol 11 (1) ◽  
pp. 35-40 ◽  
Author(s):  
Mohammed Yousef-Mian

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.


2018 ◽  
Author(s):  
Ceyhun Cengiz ◽  
Münir Demirci ◽  
Şule Demirci ◽  
Necmi Arslan ◽  
Ceren Ersöz Ünlü ◽  
...  

1996 ◽  
Vol 115 (1) ◽  
pp. 163-166 ◽  
Author(s):  
Don N. Lerner

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.


1997 ◽  
Vol 111 (5) ◽  
pp. 435-437 ◽  
Author(s):  
A. Hussain ◽  
P. Murthy

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.


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.


2020 ◽  
pp. 019459982094221
Author(s):  
Samih J. Nassif ◽  
Andrew R. Scott

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.


2009 ◽  
Vol 124 (1) ◽  
pp. 48-54 ◽  
Author(s):  
H P Lee ◽  
R R Garlapati ◽  
V F H Chong ◽  
D Y Wang

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.


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