Department of Otorhinolaryngology, Ministry of Health Ankara Training and Research Hospital, Turkey.
Am J Rhinol Allergy. 2012 May-Jun;26(3):237-42. doi: 10.2500/ajra.2012.26.3765.
Repair of nasal septal perforations is one of the most challenging procedures in nasal surgery. The aim of this prospective clinical study was to determine the efficacy of using an inferior turbinate composite graft (ITCG) for the repair of nasal septal perforation.
Between 2009 and 2011, 27 consecutive patients with nasal septal perforation underwent endoscopy-assisted, endonasal septal perforation repair by using an ITCG alone or in combination with bipedicled mucosal advancement flap.
Complete closure of the perforation was achieved in 24 of 27 (88.8%) patients, and incomplete closure was observed in 2 patients with medium-sized perforation and 1 patient with large perforation.
The ITCG technique provides three-layer repair of the defect under no tension in closure of small perforations located anteriorly, posterior perforations with mucosal atrophy, or previous unsuccessful surgical repair. In graft-depleted revision rhinoplasty cases with small-sized septal perforations, this technique provides a simple solution with autogenous grafts. In cases involving larger perforations, the ITCG technique can easily be combined with bipedicled flap and allows for more options to solve a challenging problem. Current data from this prospective study suggest that this surgical technique may be used in the repair of nasal septal perforation.
鼻中隔穿孔的修复是鼻外科中最具挑战性的手术之一。本前瞻性临床研究旨在评估使用下鼻甲复合移植物（ITCG）修复鼻中隔穿孔的疗效。
2009 年至 2011 年间，27 例鼻中隔穿孔患者接受了内镜辅助、经鼻鼻中隔穿孔修复术，单独或联合使用双蒂黏膜推进瓣。
27 例患者中，24 例（88.8%）穿孔完全闭合，2 例中等大小穿孔和 1 例大穿孔患者不完全闭合。
ITCG 技术在修复前、后穿孔，黏膜萎缩或先前手术修复失败的小穿孔时，提供无张力的三层修复。在复发性鼻中隔穿孔且移植物不足的病例中，对于小穿孔，该技术提供了一种简单的自体移植物解决方案。对于较大穿孔，ITCG 技术可与双蒂皮瓣轻松结合，为解决具有挑战性的问题提供更多选择。本前瞻性研究的现有数据表明，该手术技术可用于修复鼻中隔穿孔。
