Sand Jordan P, Desai Shaun C, Branham Gregory H
St. Louis, Mo. From the Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Washington University School of Medicine.
Plast Reconstr Surg. 2015 Oct;136(4):700-703. doi: 10.1097/PRS.0000000000001571.
Medium to large septal perforations are a challenging problem to the rhinoplasty surgeon. In this study, records and outcomes are reviewed for 25 patients who underwent septal perforation repair over a 10-year period. All patients underwent an open septorhinoplasty approach with use of bilateral opposing mucoperichondrial flaps and a unique intervening graft that included acellular dermis, temporalis fascia alone, or a novel closure technique using temporalis fascia and a polydioxanone plate. The authors identify that for medium to large septal perforations, the use of the polydioxanone plate with temporalis fascia provided the highest rate of closure as a method of scaffolding a fascial graft, and also provided ease of placement between opposing mucoperichondrial flaps.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
中到大型鼻中隔穿孔对外鼻整形医生来说是个具有挑战性的问题。在本研究中，回顾了25例在10年期间接受鼻中隔穿孔修复患者的记录及治疗结果。所有患者均采用开放式鼻中隔鼻整形术，使用双侧相对的黏骨膜瓣以及一种独特的介入移植物，该移植物包括脱细胞真皮、单独的颞肌筋膜，或一种使用颞肌筋膜和聚二氧六环酮板的新型闭合技术。作者发现，对于中到大型鼻中隔穿孔，使用带颞肌筋膜的聚二氧六环酮板作为支撑筋膜移植物的方法，闭合率最高，并且在相对的黏骨膜瓣之间易于放置。
临床问题/证据级别：治疗性，四级。
