Department of Otolaryngology - Head and Neck Surgery, Cleveland Clinic Head and Neck Institute, Cleveland, OH, United States of America.
Section of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Cleveland Clinic Head and Neck Institute, Cleveland, OH, United States of America.
Am J Otolaryngol. 2023 Jul-Aug;44(4):103883. doi: 10.1016/j.amjoto.2023.103883. Epub 2023 Apr 5.
Nasal septal perforation (NSP) repair is a complex procedure with variable techniques and success rates. In this study we describe NSP repair using a trilayer interposition graft of temporalis fascia and thin polydioxanone (PDS) plate without intranasal flaps and report outcomes in our patient population.
IRB-approved retrospective review of 20 consecutive patients presenting to a tertiary medical center with NSP from September 2018 to December 2020 and who underwent NSP repair via our trilayer temporalis fascia interposition graft. De-identified patient data was obtained from the medical record and stored on an encrypted secure server. Descriptive statistics were examined for each variable.
All 20 NSP repairs demonstrated durable repair with complete mucosal coverage at last follow-up (average 7 months). Complete resolution of preoperative symptoms was achieved in 85 % of patients, with partial resolution in the remaining 15 %. Of the 20 perforations 25 % were small (<1 cm), 50 % medium (1-2 cm), and 25 % large (>2 cm). The only surgical complication was a single intranasal synechiae. No graft harvest site complications were noted.
The application of a trilayer temporalis fascia - PDS plate interposition graft without intranasal flaps is highly effective for repair of NSP.
鼻中隔穿孔(NSP)修复是一项复杂的手术,其技术和成功率各不相同。本研究采用颞筋膜三层间置移植物和薄聚二氧杂环己酮(PDS)板修复 NSP,不使用鼻内皮瓣,并报告我们患者群体的结果。
对 2018 年 9 月至 2020 年 12 月在三级医疗中心因 NSP 就诊并通过我们的三层颞筋膜间置移植物修复的 20 例连续患者进行了 IRB 批准的回顾性研究。从病历中获取了患者数据,并存储在加密的安全服务器上。对每个变量进行了描述性统计分析。
所有 20 例 NSP 修复均表现出持久修复,最后一次随访时黏膜完全覆盖(平均 7 个月)。85%的患者术前症状完全缓解,15%的患者部分缓解。20 个穿孔中,25%为小穿孔(<1cm),50%为中穿孔(1-2cm),25%为大穿孔(>2cm)。唯一的手术并发症是单一的鼻内粘连。未发现移植物采集部位并发症。
不使用鼻内皮瓣的颞筋膜-PDS 板三层间置移植物在修复 NSP 方面非常有效。