Pedroza Fernando, Patrocinio Lucas Gomes, Arevalo Osiris
Department of Facial Plastic Surgery, CES University, Bogotá, Colombia.
Arch Facial Plast Surg. 2007 Jan-Feb;9(1):12-8. doi: 10.1001/archfaci.9.1.12.
To report the long-term follow-up of 25 years of experience in 100 consecutive cases of septal perforation (SP) repair using the technique of the senior author (F.P.).
From 1981 to 2006, a total of 100 consecutive patients were surgically treated and followed up for 1 to 10 years. The medical records of 68 of the patients were retrospectively examined. Outcomes were assessed based on comparison of the results of preoperative and last follow-up assessment of SP size and symptoms. The SP repair technique consists of subperichondrial/periosteal dissection, rotation of nasal mucosa for tension-free closure, with no mucosa incision if possible, and a multilayer closure with interposition graft.
The most common symptoms were nasal obstruction (72%), crusts (50%), and epistaxis (31%). Previous nasal surgery was the pathogenetic factor in 39 cases (57%). Fifty-two patients (76%) presented with SPs measuring 1.0 to 3.0 cm in diameter. The internal approach was used in 54 cases (79%), and temporal muscle fascia and conchal cartilage were concomitantly used in 45 cases (66%). The great majority of patients (40 [59%]) received more than 5 years of follow-up. The success rate of closure was 97%. Two patients (3%) presented with reperforation measuring less than 1.0 cm in diameter.
The senior author's SP repair technique is easily accomplished, provides good visualization, and is low in cost. Also, in our experience, the success rate of closure has been 97%.
报告资深作者（F.P.）采用其技术连续100例鼻中隔穿孔（SP）修复25年的长期随访情况。
1981年至2006年，共100例患者接受手术治疗并随访1至10年。对其中68例患者的病历进行回顾性检查。通过比较术前和末次随访时SP大小及症状的评估结果来评估疗效。SP修复技术包括软骨膜下/骨膜下剥离、旋转鼻黏膜以实现无张力闭合，尽可能不切开黏膜，以及采用植入移植物的多层闭合。
最常见的症状为鼻塞（72%）、结痂（50%）和鼻出血（31%）。既往鼻部手术是39例（57%）的致病因素。52例患者（76%）的SP直径为1.0至3.0厘米。54例（79%）采用经鼻入路，45例（66%）同时使用颞肌筋膜和耳甲软骨。绝大多数患者（40例[59%]）接受了超过5年的随访。闭合成功率为97%。2例患者（3%）出现直径小于1.0厘米的再次穿孔。
资深作者的SP修复技术操作简便，视野良好，成本低廉。此外，根据我们的经验，闭合成功率为97%。
