Meghachi A S, Jankowski R, Védrine P O, Dugny O
Service d'ORL et de Chirurgie Cervico Faciale, Hôpital Central, avenue de Lattre de Tassigny, 54000 Nancy, France.
Ann Otolaryngol Chir Cervicofac. 2004 Sep;121(4):222-8. doi: 10.1016/s0003-438x(04)95512-0.
We present a technique of endoscopic endonasal closure of average sized (0.5 - 2 cm) to large (>2 cm) septal perforations.
The surgical technique involves a mucosal rotation flap on a unilateral posterior pedicle without interposition material. We reviewed our experience with eleven patients with average sized and large septal perforations treated over an 8-year period.
We based our evaluation on the model proposed by Younger and Blokmanis. Our results were comparable with earlier publications. One-phase closure was achieved in 75% of patients (55% to 90% in the literature reporting all techniques, including external septorhinoplasty and midfacial degloving).
Our preliminary series provides a basis for a new approach to this condition. The technique is promising for large perforations. This technique could also be considered for other nasal fossae in the event of failed closure. It also offers a way to obtain excellent closure of the anterior portion of the perforation, relieving the patient of the most annoying symptoms. The technique does not contraindicate other procedures which may be performed during the same operation or later.
我们介绍一种经鼻内镜鼻内闭合平均大小（0.5 - 2厘米）至大尺寸（>2厘米）鼻中隔穿孔的技术。
手术技术包括在单侧后蒂上制作黏膜旋转瓣，不使用置入材料。我们回顾了8年间治疗的11例平均大小和大尺寸鼻中隔穿孔患者的经验。
我们依据扬格和布洛克马尼提出的模型进行评估。我们的结果与早期出版物相当。75%的患者实现了一期闭合（在报道所有技术的文献中，包括外鼻鼻中隔成形术和面中部去套状手术，这一比例为55%至90%）。
我们的初步系列研究为此病症的新治疗方法提供了依据。该技术对于大穿孔很有前景。如果闭合失败，此技术也可用于其他鼻窝。它还提供了一种实现穿孔前部完美闭合的方法，缓解了患者最恼人的症状。该技术并不妨碍在同一手术期间或之后可能进行的其他手术。
