Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clínic, IDIBAPS, CIPERES, Barcelona University. Barcelona.
Department of Otorhinolaryngology, Clinica Universidad de Navarra, University of Navarra, Pamplona.
Curr Opin Otolaryngol Head Neck Surg. 2023 Feb 1;31(1):11-16. doi: 10.1097/MOO.0000000000000857. Epub 2022 Dec 6.
To provide a comprehensive overview of the evolution of the different techniques described for the surgical repair of nasal septal perforation, and a surgical decision-making algorithm for its surgical treatment.
Septal perforation surgery has evolved and improved in recent years. It has gone from being an avoided or discouraged surgical procedure to a procedure with success rates of >90%. Nowadays, there is no standard approach or single technique. The different techniques described include unilateral random pattern flaps, interposition grafts, unilateral pedicle septal local flaps, free mucosal grafts and bilateral random patter flaps. The incidence of success is higher in pediculated septal flaps such as the anterior ethmoidal artery flap or the greater palatine artery pedicled flap combined with additional techniques.
Nowadays, surgical closure of septal perforation is possible and should be an option to consider in symptomatic patients without response to medical treatment. The surgical approach that we recommend when planning the surgical closure of nasal septum (or nasoseptal) perforation is based on the osseocartilaginous support and the location of the defect.
提供不同技术修复鼻中隔穿孔的全面概述，并制定鼻中隔穿孔手术治疗的决策算法。
近年来，鼻中隔穿孔手术不断发展和完善。它已从避免或不鼓励的手术转变为成功率>90%的手术。如今，没有标准的方法或单一技术。所描述的不同技术包括单侧随意皮瓣、鼻中隔移植、单侧带蒂鼻中隔局部皮瓣、游离黏膜移植和双侧随意皮瓣。带蒂鼻中隔皮瓣（如筛前动脉瓣或腭大动脉带蒂瓣）结合其他技术的成功率更高。
如今，鼻中隔穿孔的手术闭合是可能的，对于药物治疗无反应的有症状患者，应将其作为一种选择。在计划鼻中隔（或鼻-鼻中隔）穿孔的手术闭合时，我们推荐的手术方法基于骨软骨支撑和缺损的位置。
