ENT Department, East Garda Bussolengo (VR), Italy.
Acta Otorhinolaryngol Ital. 2013 Jun;33(3):202-14.
traumatic, iatrogenic, infectious, degenerative, overuse of vasoconstrictors, abuse of cocaine and more recently chemotherapy agents. Perforations are also classified according to their size and type of cartilaginous or osteocartilaginous deficit, as well as location (front, middle and rear). Many surgical techniques have been proposed to repair the perforation, although the results are often unsatisfactory for perforations of small and medium size; in large perforations permanent obliteration of the defect cannot always be ensured. It is often necessary to use tissues from inside the nasal turbinates or cartilage from other donor sites such as the ear or rib, and various techniques are discussed in light of the recent literature. The perforations observed in the last eight years and surgical approaches performed in open or closed approaches are taken into account. The authors propose a new technique that has been used with success in many types of septal perforation regardless of aetiology, and in particular large perforations, which allows for the use of the osteocartilaginous donor site as a hump. It is also useful in reductive rhinoseptoplasty, which targets selection to easily obtain mucopericondral flaps with an extramucosal technique and to obtain also an aesthetic improvement.
创伤性、医源性、感染性、退行性、血管收缩剂滥用、可卡因滥用以及最近的化疗药物等因素均可导致穿孔。根据穿孔的大小和软骨或骨软骨缺损的类型，以及位置（前、中、后），对穿孔进行分类。虽然对于小到中等大小的穿孔，许多手术技术都被提出用于修复穿孔，但结果往往并不令人满意；对于大穿孔，永久性地封闭缺损有时无法确保。通常需要使用来自鼻腔鼻甲内部的组织或来自其他供体部位的软骨，例如耳朵或肋骨，并且根据最新文献讨论了各种技术。考虑了在过去八年中观察到的穿孔以及在开放式或封闭式方法中进行的手术方法。作者提出了一种新技术，无论病因如何，尤其是对于大穿孔，该技术都已成功应用于多种类型的鼻中隔穿孔，并且可以利用骨软骨供体部位作为驼峰。在缩窄性鼻成形术中，该技术也很有用，它针对的是选择使用粘膜外技术轻松获得粘膜下皮瓣，并获得美学改善。
