scholarly journals Surgical Outcome and Complications of Nasal Septal Perforation Repair with Temporal Fascia and Periosteal Grafts

2015 ◽  
Vol 8 ◽  
pp. CMENT.S23230 ◽  
Author(s):  
Paula Virkkula ◽  
Antti a. Mäkitie ◽  
Seija i. Vento
Keyword(s):  
Postoperative Infection ◽  
Donor Site ◽  
Neck Surgery ◽  
University Hospital ◽  
Septal Perforation ◽  
Temporal Fascia ◽  
Nasal Septal Perforation ◽  
Main Technique ◽  
Advancement Flaps

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.

scholarly journals Septoplasty with and without additional sinonasal surgery: postoperative sequelae and the use of prophylactic antibiotics

2021 ◽  
Author(s):  
Ida Kotisalmi ◽  
Maija Hytönen ◽  
Antti A. Mäkitie ◽  
Markus Lilja
Keyword(s):  
Infection Rate ◽  
Postoperative Infection ◽  
Patient Characteristics ◽  
Neck Surgery ◽  
Prophylactic Antibiotics ◽  
University Hospital ◽  
Postoperative Infections ◽  
Prophylactic Measure ◽  
Prophylaxis Group

Abstract Purpose One of the most common complications after septoplasty is a postoperative infection. We investigated the number of postoperative infections and unplanned postoperative visits (UPV) in septoplasties with and without additional nasal surgery at our institution and evaluated the role of antibiotic prophylaxis. Methods We collected data of all consecutive 302 septoplasty or septocolumelloplasty patients operated during the year 2018 at the Department of Otorhinolaryngology-Head and Neck Surgery, HUS Helsinki University Hospital (Helsinki, Finland). Hospital charts were reviewed to record sociodemographic patient characteristics and clinical parameters regarding surgery and follow-up. Results Altogether 239 patients (79.1%) received pre- and/or postoperative prophylactic antibiotics and within this group 3.3% developed a postoperative infection. The infection rate in the non-prophylaxis group of 63 patients was 12.7% (p = 0.007). When all patients who received postoperative antibiotics were excluded, we found that the infection rate in the preoperative prophylaxis group was 3.8%, as opposed to an infection rate of 12.7% in the non-prophylaxis group (p = 0.013). When evaluating septoplasty with additional sinonasal surgery (n = 115) the rate of postoperative infection was 3.3% in the prophylaxis group and 16.7% in the non-prophylaxis group (p = 0.034). These results show a statistically significant stand-alone effect of preoperative prophylactic antibiotics in preventing postoperative infection in septoplasty, especially regarding additional sinonasal surgery. Conclusion The use of preoperative antibiotics as a prophylactic measure diminished statistically significantly the rate of infections and UPVs in septoplasty when all postoperative infections, superficial and mild ones included, were taken into account.

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
Keyword(s):  
Nasal Obstruction ◽  
Septal Perforation ◽  
Nasal Septal Perforation

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.

scholarly journals Temporoparietal Fascia Free Flap for a Large Nasal Septal Perforation

2019 ◽  
Vol 04 (01) ◽  
pp. e42-e46
Author(s):  
Nicholas G. Cuccolo ◽  
Ryan P. Cauley ◽  
Brady A. Sieber ◽  
Syed M.D. Hussain ◽  
Laurel K. Chandler ◽  
...  
Keyword(s):  
Medical Condition ◽  
Donor Site ◽  
Free Tissue Transfer ◽  
Donor Site Morbidity ◽  
Nasal Septal Perforation ◽  
Temporoparietal Fascia ◽  
Versatile Tool ◽  
Underlying Medical Condition

AbstractReconstruction of large nasal septal perforations can be a considerable challenge for surgeons. Reconstructive modalities are often determined by the size of the defect and the quality of local tissue and vasculature. Local and regional flaps may not provide enough tissue to achieve successful closure in patients with large perforations and those with baseline compromise of the nasal mucosa and blood supply from prior intervention or underlying medical condition. Microvascular free tissue transfer is a possible approach to reconstruction in these patients. We report a case of a 30-year-old man who presented with a large, symptomatic, 4 × 3.5 cm perforation as a result of prior functional septoplasty at an outside hospital. Reconstruction of the defect was accomplished in this setting with a free temporoparietal fascia (TPF) flap anastomosed to the columellar branch of the labial artery and the angular vein. Postoperative follow-up visits showed successful closure of the perforation without complications. As illustrated by this case, TPF flap is a versatile tool for complex nasal reconstructions. With minimal donor-site morbidity and rich vascularity capable of promoting remucosalization without the need for prelamination, the TPF flap may be suited for the repair of large nasoseptal perforations.

Repair of nasal septal perforations using local mucosal flaps and a composite cartilage graft

2001 ◽  
Vol 115 (1) ◽  
pp. 22-25 ◽  
Author(s):  
T. J. Woolford ◽  
N. S. Jones
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Observation Time ◽  
Cartilage Graft ◽  
Septal Perforation ◽  
Surgical Closure ◽  
Nasal Septal Perforation ◽  
Graft Donor ◽  
Conchal Cartilage Graft ◽  
Suitable Technique

The surgical closure of a nasal septal perforation is recognized as being particularly challenging. A series of 11 consecutive patients who underwent closure of a septal perforation using a mucosal flap/composite conchal cartilage graft technique are reviewed, and the surgical technique described. The size of the perforation repaired varied, with eight cases being 2 cm or more in diameter. There was no significant graft donor site morbidity and complete perforation closure was achieved in eight cases after a mean observation time of 19.8 months. These results suggest that this is a suitable technique for closing nasal septal perforation.

Nasal Septal Perforation Repair: 25-Year Experience with the Flap and Graft Technique

1994 ◽  
Vol 11 (3) ◽  
pp. 189-194 ◽  
Author(s):  
David N. F. Fairbanks
Keyword(s):  
Connective Tissue ◽  
Blood Supply ◽  
Septal Perforation ◽  
Surgical Closure ◽  
The Past ◽  
Nasal Septal Perforation ◽  
Structural Reinforcement ◽  
Flap Viability ◽  
Successful Technique ◽  
Advancement Flaps

A predictably successful technique for surgical closure of nasal septal perforation has been employed in over 100 patients in the past 25 years. It employs bipedicled mucosal advancement flaps designed to maximize blood supply (for flap viability) and an underlying connective tissue autograft (fascia or pericranium) for structural reinforcement.

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.

Bone and temporal fascia graft for the closure of septal perforation

1998 ◽  
Vol 112 (12) ◽  
pp. 1167-1171 ◽  
Author(s):  
David Núñ;ez-Fernández ◽  
Jan Vokurka ◽  
Viktor Chrobok
Keyword(s):  
Bone Graft ◽  
Study Design ◽  
Anterior Part ◽  
Donor Site ◽  
Posterior Part ◽  
Septal Perforation ◽  
Temporal Fascia ◽  
Fascia Graft ◽  
Incomplete Closure ◽  
Prospective Longitudinal

AbstractObjectivesTo assess the reliability of temporal fascia and bone graft for the closure of septal perforation.Study designProspective longitudinal non-randomized.MethodsThe repair of septal perforation was performed using endonasal dissection; suture of the borders of the perforation on at least one side, and interposition of a graft of temporal fascia with bone, either a perpendicular plate of ethmoid (six) if available or mastoid cortex (three) if not.ResultsAll patients had closure without re-perforation. Eight out of nine patients had complete closure of the perforation (88.8 per cent). These patients had perforations of less than 3 cm in diameter. The ninth patient had a perforation of more than 3 cm diameter (3.5 × 2.5 cm), and obtained a closure of about 80 per cent of the original perforation. The remaining perforation was in the posterior part of the nose. The patient was relieved of his symptoms (crusting and bleeding). This incomplete closure was most probably due to migration of the graft immediately after surgery. There was no morbidity of the donor site or the ear in the mastoid cortex graft group of patients. This is to our knowledge the first report of the use of the mastoid cortex as a graft in septal perforation.ConclusionsWe consider that the graft of temporal fascia with bone is very reliable, and the use of bone ensures closure while avoiding the complications of a lax septum in large perforations. The technique is suitable for perforations up to 2.5 cm diameter. Perforations larger than 3 cm in diameter are more difficult to close, but closure of the anterior part of the perforation will relieve the patient from the most annoying symptoms.

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.

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