Akçal Arzu, Karsidag Semra, Ozkaya Ozay, Sirvan Selami Serhat, Sevim Kamuran Zeynep, Kabukcuoglu Fevziye
Assistant Professor, Department of Plastic and Reconstructive Surgery, Akdeniz University, Antalya, Turkey.
Associate Professor, Sisli Etfal Training and Research Hospital, Plastic and Reconstructive Surgery Clinic, Istanbul, Turkey.
J Oral Maxillofac Surg. 2014 Apr;72(4):796-802. doi: 10.1016/j.joms.2013.09.034. Epub 2013 Oct 12.
The etiology of nasal septal perforations involves iatrogenic, traumatic, inflammatory, infectious, neoplastic, and caustic causes. To ensure successful closure, an appropriate interpositional graft material should be selected, and this graft material should be covered with healthy tissue.
The study included 18 New Zealand white rabbits weighing 2 to 2.5 kg. Nasal septal perforations were created in group 1. After the creation of defects in group 2, repair was performed with cartilage graft and bilateral mucoperichondrial advancement flaps. After septal nasal perforations in group 3, the defect was covered with fingernail and bilateral mucoperichondrial flaps.
At week 12, the rabbits were sacrificed. The septum site that had been repaired with fingernail was intact. No nail exposition, wound site decomposition, or re-perforation was observed. No findings of a breach of the structural integrity of the fingernails or disintegration were encountered.
Fingernails can be used as an interpositional graft material in place of cartilage in eligible cases for the repair of nasal septal perforations. Fingernails have several properties that enable their use in such cases, such as form preservation that is similar to cartilage, the lack of live cells, easy availability, and a lack of donor-site morbidity at removal.
鼻中隔穿孔的病因包括医源性、创伤性、炎症性、感染性、肿瘤性和腐蚀性原因。为确保成功闭合，应选择合适的植入移植物材料，且该移植物材料应由健康组织覆盖。
本研究纳入18只体重2至2.5千克的新西兰白兔。在第1组中制造鼻中隔穿孔。在第2组中制造缺损后，用软骨移植物和双侧黏骨膜推进瓣进行修复。在第3组中制造鼻中隔穿孔后，用指甲和双侧黏骨膜瓣覆盖缺损。
在第12周时，处死兔子。用指甲修复的鼻中隔部位完好无损。未观察到指甲外露、伤口部位分解或再次穿孔。未发现指甲结构完整性受损或分解的情况。
在符合条件的鼻中隔穿孔修复病例中，指甲可作为植入移植物材料替代软骨。指甲具有一些特性使其可用于此类病例，如与软骨相似的形态保存、无活细胞、易于获取以及移除时无供区并发症。
