Hanci Deniz, Onaran Öykü İzel, Altun Huseyin, Uyar Yavuz
Department of Otorhinolaryngology, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey.
Kocaeli Technology and Health University, Kocaeli, Turkey.
Ear Nose Throat J. 2024 Nov;103(3_suppl):93S-98S. doi: 10.1177/01455613241271700. Epub 2024 Sep 21.
Nasal septal perforation (NSP) is a structural anomaly that affects the mucosa, cartilage, and bone of the nasal septum, often stemming from septoplasty as the primary cause. Spontaneous healing of a perforated septum is rare, and typically the healing process is observed until it is determined that the condition is stable and no longer deteriorating, at which point surgical intervention is considered. Numerous surgical techniques have been proposed for NSP repair. This study introduces a novel approach incorporating a fascia lata graft with fat tissue and diced septal cartilage to reconstruct medium-sized NSP. The researchers conducted a retrospective analysis involving 22 patients who underwent repair for NSP from January 2021 to January 2023. Grafts were obtained, and the perforation was addressed using an open rhinoplasty technique, followed by the insertion and suturing of the graft. The mean size of the septal perforations was 12 mm horizontally and 13 mm vertically. All patients with NSPs were chosen as medium size (within 0.5-2 cm). The mean follow-up period was 12 months. Complete closure of NSP was achieved in 19 out of 22 patients (86.3%). Among the cases, 15 were male (68%), and the ages ranged from 25 to 45 years with a mean of 35. Eight cases (36%) were smokers. After 12 months postoperatively, closure was not achieved in 3 medium-sized NSPs due to smoking. . The analysis revealed that the failure rate in the smoker group was statistically significant ( = .036). The TriCelluFuse technique, combining fascia lata, fat tissue, and diced septal cartilage, is a secure and reliable method for closing NSPs. It has a significant success rate and should be considered a viable option for individuals with NSPs.
鼻中隔穿孔(NSP)是一种影响鼻中隔黏膜、软骨和骨质的结构异常,通常由鼻中隔成形术作为主要病因引起。鼻中隔穿孔自发愈合的情况罕见,通常在确定病情稳定且不再恶化之前观察愈合过程,此时才考虑手术干预。针对NSP修复已提出了众多手术技术。本研究引入了一种将阔筋膜移植与脂肪组织及切碎的鼻中隔软骨相结合的新方法,用于重建中型NSP。研究人员对2021年1月至2023年1月期间接受NSP修复的22例患者进行了回顾性分析。获取移植物,采用开放式鼻整形术技术处理穿孔,随后插入并缝合移植物。鼻中隔穿孔的平均水平尺寸为12毫米,垂直尺寸为13毫米。所有NSP患者均被选为中型(0.5 - 2厘米范围内)。平均随访期为12个月。22例患者中有19例(86.3%)实现了NSP的完全闭合。其中,15例为男性(68%),年龄在25至45岁之间,平均年龄为35岁。8例(36%)为吸烟者。术后12个月时,3例中型NSP因吸烟未实现闭合。分析显示,吸烟者组的失败率具有统计学意义(=0.036)。TriCelluFuse技术,即结合阔筋膜、脂肪组织和切碎的鼻中隔软骨,是一种安全可靠的闭合NSP的方法。它具有显著的成功率,应被视为NSP患者的可行选择。