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采用前上颌窦壁作为间置物修复鼻中隔穿孔的长期疗效。

Long-Term Outcomes of Nasoseptal Perforation Repair Using Anterior Maxillary Sinus Wall as an Interpositional Graft.

机构信息

College of Medicine, 36899Korea University, Seoul, South Korea.

出版信息

Am J Rhinol Allergy. 2022 Mar;36(2):238-244. doi: 10.1177/19458924211049608. Epub 2021 Oct 12.

Abstract

BACKGROUND

Various graft materials have been used to repair nasoseptal perforation, but there is no standardized treatment method. The anterior maxillary sinus wall is flattened in appearance and can be easily obtained in a sufficient amount for a large-sized nasoseptal perforation.

OBJECTIVES

The aim of this study is to determine whether the anterior maxillary sinus wall is suitable as an interpositional graft in the surgical repair of septal or nasoseptal perforation.

METHODS

This is a retrospective review of 21 patients who underwent repair of nasoseptal perforation using anterior maxillary sinus wall as an interpositional graft. The etiology pre- and post-operative NOSE and GBI score, and perforation size were reviewed. The surgical outcome was considered successful if total closure was achieved after postoperative follow-up.

RESULTS

19 of the 21 perforations were successfully repaired with anterior maxillary sinus wall. Failure of the repair was found in 2 patients. Causal etiology of perforation was previous septoplasty in 10 patients, and electrocautery in 1 case, but not identified in 10 cases. The largest size was 2.7 × 2.2 cm. The most common symptoms were epistaxis, crusting, and nasal obstruction. Closure of septal perforation resulted in improved subjective symptoms and quality of life which were evaluated with NOSE and GBI score.

CONCLUSION

Anterior maxillary sinus wall as interpositional graft between mucoperichondrial flaps can be used to reliably repair nasoseptal perforations.

摘要

背景

各种移植物材料已被用于修复鼻中隔穿孔,但尚无标准化的治疗方法。前上颌窦壁外观平坦,可大量获得,适用于大型鼻中隔穿孔。

目的

本研究旨在确定前上颌窦壁是否适合作为鼻中隔或鼻中隔穿孔修复手术中的间置物。

方法

这是一项回顾性研究,共纳入 21 例采用前上颌窦壁作为间置物修复鼻中隔穿孔的患者。回顾术前和术后的 NOSE 和 GBI 评分以及穿孔大小。如果术后随访时完全闭合,则认为手术结果成功。

结果

21 个穿孔中有 19 个用前上颌窦壁成功修复。2 例修复失败。穿孔的病因包括 10 例鼻中隔成形术和 1 例电灼术,10 例未明确。最大穿孔大小为 2.7×2.2cm。最常见的症状是鼻出血、结痂和鼻塞。鼻中隔穿孔的闭合导致主观症状和生活质量的改善,这通过 NOSE 和 GBI 评分进行评估。

结论

在前上颌窦黏膜瓣之间使用前上颌窦壁作为间置物可可靠地修复鼻中隔穿孔。

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