scholarly journals Nasal Septal Perforation: Experience of Management

2021 ◽  
Vol 28 (3) ◽  
pp. 255-259
Author(s):  
Selçuk Kuzu ◽  
Çağlar Günebakan
Keyword(s):  
Nasal Septum ◽  
Inflammatory Diseases ◽  
Nasotracheal Intubation ◽  
Septal Perforation ◽  
Closure Rate ◽  
Composite Tissue ◽  
Nasal Septal Perforation ◽  
Common Causes ◽  
Septum Perforation ◽  
Nasal Septum Perforation

Introduction Nasal septal perforation is the loss of composite tissue comprising the mucosa, bone or cartilage structures that form the nasal septum. Nasal septum perforation has many causes. Though it may be idiopathic, the most common causes are iatrogenic like nasal surgeries. Among other reasons are septal hematoma, nasal picking habit, nasal cauterization due to nosebleeds, nasotracheal intubation, cocaine use, vasculitis, inflammatory diseases such as sarcoidosis, This study aims to review the approach to management of patients with nasal septal perforation who underwent repair of the perforation in a tertiary clinic, in the light of current literature. Materials and Methods In this study, the records of 27 patients who were diagnosed with nasal septal perforation and treated surgically in a tertiary clinic, between January 2015 and June 2019 were reviewed retrospectively. Results The successful closure rate of perforations was 74%. In 4 of 7 patients whose perforations were not completely closed, the perforation size was larger than 2 cm in diameter. Conclusion Successful repair of nasal septal perforation depends largely on the cause, location, size of the perforation, cartilage bone tissue on the perforation edges, surgical technique and the surgeon's experience.

Nasal septal perforation repair using open septoplasty and unilateral bipedicled flaps

2003 ◽  
Vol 117 (1) ◽  
pp. 52-55 ◽  
Author(s):  
J. R. Newton ◽  
P. S. White ◽  
M. S. W. Lee
Keyword(s):  
Posterior Edge ◽  
Closure Rate ◽  
Nasal Septal Perforation ◽  
Symptom Scores ◽  
Septum Perforation ◽  
Nasal Septum Perforation ◽  
And Control ◽  
Flap Closure

The aim of this study was to assess the success of the technique of open septoplasty with bipedicled flaps in achieving long-term closure and control of symptoms. Between 1993 and 2000, 32 patients underwent surgery for nasal septum perforation. Twenty patients with large perforations underwent posterior edge repair only. The remaining 12 patients (five female, and seven male) with perforations less than 20 mm in diameter underwent open septoplasty and a unilateral bipedicled flap closure. A retrospective review involving a symptom scores assessment and follow-up examination was conducted. One patient died of unrelated illness, and was excluded. Results showed 10 of the remaining 11 patients achieved closure after a mean follow up of 10 months. The symptoms of crusting (p < 0.0001), epistaxis (p < 0.02), discharge (p < 0.012), whistling (p < 0.011), and overall discomfort (p < 0.02), were all significantly improved. We conclude that by using this technique on patients with small perforations less than 20 mm, it is possible to achieve up to a 90 per cent perforation closure rate, and a significant improvement in patients’ symptoms.

scholarly journals Nasal septum perforation – new treatment methods

New Medicine ◽  
2018 ◽  
Vol 22 (3) ◽  
Author(s):  
Michał Michalik ◽  
Adrianna Podbielska-Kubera ◽  
Agnieszka Dmowska-Koroblewska
Keyword(s):  
Nasal Septum ◽  
Trauma Surgery ◽  
Underlying Disease ◽  
Surgical Approaches ◽  
Surgical Closure ◽  
Temporal Fascia ◽  
Nasal Septal Perforation ◽  
Detailed Medical History ◽  
Septum Perforation ◽  
Nasal Septum Perforation

Perforation is a defect of nasal septum manifested by the disruption of mucosa in the cartillaginous or bone part of nasal septum or in both of the parts at the same time.As a result, disruption of air transport through the nose and impaired nasal physiology occur. Crusting, epistaxis, and wheezing arise. Perforations are classified according to their size, type, and localization. There are many causes for nasal septum perforation: trauma, surgery, tumors, coexistence of inflammatory, infectious, degenerative, and autoimmune diseases, and cocaine abuse. The assessment of a patient with nasal septum perforation includes detailed medical history, physical examination, diagnostic and laboratory tests. Treating the underlying disease is of primary importance. The second step involves closing the perforation. Perforations can be treated conservatively (pharmacologically) or surgically. The choice of approach depends on the etiology, size, and location of the perforation. Surgical approach is the most effective. Surgical closure of nasal septal perforation is a difficult procedure associated with many complications. All surgical approaches are based on two main principles: creating mucosal, mucoperichondrial, and/or mucoperiosteal flaps or transplant. Prosthetic treatment is another solution. Literature data shows that highest success rate is achieved after surgical procedures with the use of mucosal flaps and temporal fascia transplants, as well as acellular human dermal allografts.

scholarly journals Huge hard palate and nasal septum perforation as a presentation of syphilis: A case report

2012 ◽  
Vol 11 (3) ◽  
pp. 234-237
Author(s):  
B Shahrjerdi ◽  
I Mohamad
Keyword(s):  
Case Report ◽  
Nasal Septum ◽  
Hard Palate ◽  
Medical Science ◽  
Underlying Disease ◽  
Septal Perforation ◽  
Diagnostic Challenge ◽  
Septum Perforation ◽  
Nasal Septum Perforation ◽  
Septal Perforations

A patient presented with septal and palatal perforations imposes a diagnostic challenge because various potential causes need to be established. Therefore, elucidating the cause of the septal perforation requires obtaining a thorough history. In addition, it is very important to perform necessary investigations for the patients to determine and fix the underlying disease which cause these complaints. We report a case of patient presented with palatal and septal perforations which later was confirmed to have syphilis. DOI: http://dx.doi.org/10.3329/bjms.v11i3.11737 Bangladesh Journal of Medical Science Vol. 11 No. 03 July’12

Party Lines and Other Mucosal Crimes: Nasal Septal Perforation: A Review of Common and Uncommon Causes

Neurographics ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 182-195
Author(s):  
C.S. Taylor ◽  
T.A. Nichols ◽  
D.A. Joyner
Keyword(s):  
Differential Diagnosis ◽  
Nasal Septum ◽  
Clinical Symptoms ◽  
Septal Cartilage ◽  
Preoperative Imaging ◽  
Imaging Features ◽  
Septal Perforation ◽  
Ischemic Necrosis ◽  
Nasal Septal Perforation ◽  
Common Causes

Nasal septal perforation refers to the abnormal communication of the nasal cavities via a defect in the nasal septum. Clinical symptoms, if present, include bleeding, crusting, a sensation of nasal obstruction, and whistling noises during inhalation. The mucoperichondrium of the nasal cavity contains most of the nasal septal vasculature and sandwiches the relatively avascular septal cartilage. An insult to the mucoperichondrium on both sides of the septal cartilage in approximately the same area results in ischemic necrosis of the septal cartilage, which leads to nasal septal perforation. Nasal septal perforation is a common end to an expansive list of etiologies that occur due to ischemic necrosis or direct erosion of the osteocartilaginous nasal septum from a tumor or infection. Imaging alone is typically insufficient to establish the exact underlying etiology. However, there are imaging features that may narrow the differential diagnosis or suggest less common causes, particularly malignancy. Radiologists can also identify lesions that place the nasal septum at risk, such as for a nasal septal hematoma or an abscess. Preoperative imaging allows for the evaluation of the size of the defect, as well as other areas of osseous and cartilaginous destruction in the palate, sinus walls, or orbits, that may need surgical reconstruction.Learning Objective: Describe nasal septal anatomy, pathophysiology of nasal septal perforation, and the differential diagnosis for causes of nasal septal perforation.

Experience of using the P. Castelnuovo flap in the postoperative nasal septal perforation repair

2021 ◽  
Vol 20 (4) ◽  
pp. 27-32
Author(s):  
I. I. Morozov ◽  
◽  
N. S. Grachev ◽  
◽  
Keyword(s):  
Postoperative Period ◽  
Nasal Septum ◽  
Inferior Turbinate ◽  
Mucociliary Transport ◽  
Secondary Intention ◽  
Nasal Septal Perforation ◽  
Number Of Patients ◽  
Septum Perforation ◽  
Nasal Septum Perforation ◽  
Flap Closure

Postoperative nasal septum perforation (PNSP) is a complication of nasal septum (NS) surgery with an incidence of 1–8%. The effectiveness of surgical treatment ranges from 52 to 92%. In world practice, Castelnuovo operation is actively used, while the effectiveness of this technique in the treatment of PNSP requires a comprehensive study. Objectives: To assess the effectiveness of the method of closing the PNSP with a Castelnuovo flap. Materials and methods: 26 patients with PNSP were operated on. The number of patients depending on the area (S) of the PNSP: S <1 cm2 – 2, S 1–2 cm2 – 21, S > 2 cm2 – 3. In the postoperative period, cytological examination of smears from the NS surface was carried out (3rd, 6th, 10th, 15th, 20th days), questionnaire survey NOSE and assessment of mucociliary transport of the mucous membrane (MM) of the nasal cavity (10th, 15th, 20th, 25th and 30th, 40th 60th day), the presence of relapses of PNSP within 1 year were performed. Results: pronounced leukocyte infiltration and bacterial contamination of the wound were revealed up to 10 days, reparative processes were not expressed until 15 days. The indicators of mucociliary transport were brought back to normal by the 30th day (21,25 ± 1,90 minutes), the results of the NOSE questionnaire by the 60th day were 22.12 points, which corresponded to the zone of comfortable breathing. In all 26 patients, intraoperatively complete closure of the PNSP was performed. There were 7 recurrences of PNSP: 3 in the interval of 16–30 days, 2 – from 31 to 60 days, 1 – from 61 to 90 days, 1 – from 4 to 6 months. Synechiae between NS and inferior turbinate was found in 11,5%. The efficiency of Castelnuovo flap closure technique of PNSP was 73%. Conclusions: The results indicate a pronounced inflammation in the flap and NS tissues in the postoperative period and a change in the physiological course of the wound process in favor of healing by secondary intention.

Nasal Septum Perforation of Welders

1998 ◽  
Vol 10 (3) ◽  
pp. 404 ◽  
Author(s):  
Choong Ryeol Lee ◽  
Cheol In Ryu ◽  
Ji Ho Lee ◽  
Jeong Hak Kang ◽  
Seong Kyu Kang ◽  
...  
Keyword(s):  
Nasal Septum ◽  
Septum Perforation ◽  
Nasal Septum Perforation

scholarly journals Nasal septum perforation as the presenting sign of lupus erythematosus

2005 ◽  
Vol 11 (2) ◽  
Author(s):  
R Mascarenhas ◽  
O Tellechea ◽  
H Oliveira ◽  
JP Reis ◽  
M Cordeiro ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Nasal Septum ◽  
Septum Perforation ◽  
Nasal Septum Perforation

scholarly journals Rheumatoid Arthritis Complicated with Nasal Septum Perforation Due to Methotrexate-associated Lymphoproliferative Disorder

2019 ◽  
Vol 58 (21) ◽  
pp. 3167-3171 ◽  
Author(s):  
Ryuki Sakaguchi ◽  
Keita Fujikawa ◽  
Momoko Okamoto ◽  
Emi Matsuo ◽  
Kohei Matsumoto ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Nasal Septum ◽  
Lymphoproliferative Disorder ◽  
Septum Perforation ◽  
Nasal Septum Perforation
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