Omer Goran Latif, Di Girolamo Stefano, Ali Sahand Soran, Kareem Rekawt Hama Rashid, Abdullah Aland Salih, Maurizi Riccardo, Velletrani Gianluca, Francavilla Beatrice, Hussein Othman, Noori Kosar Hama, Ahmed Aso Khasraw, Hamaamin Amanj Hamaamin
College of Medicine, Department of Clinical Sciences, University of Sulaimani, Sulaymaniyah, Iraq.
Department of Otorhinolaryngology, University of Rome Tor Vergata, Rome, Italy.
Eur Arch Otorhinolaryngol. 2025 Mar;282(3):1335-1343. doi: 10.1007/s00405-024-09136-4. Epub 2024 Dec 12.
Septal perforation refers to a defect within the nasal septum, which subsequently creates communication between the two nasal cavities. More than one surgical approach has been described to repair nasal septal perforations; however, they have a high rate of complication. We aim to introduce a new technique of endoscopic repair of septal perforations, which supports the flap and is thus used to prevent commonly encountered complications.
This is a prospective cohort study with 40 patients who underwent thorough clinical examination, including nasal endoscopy, to determine the perforation details. This was followed by computed tomography (CT) scans and blood tests, which were done to exclude granulomatous disease, tumours, base of skull defects, polyps, etc. This new technique uses either a piece of cartilage alone or cartilage combined with a bone to support the flap. In the assessment, the perforation sizes were categorized, and a treatment plan was made for each.
The patients in the study were evaluated, and their most common complaint was crusting. Most patients with less than 1 cm perforations did not need support; the majority of those with 1-2 cm perforations required cartilage support, and 2-3 cm perforations required cartilage and bone support.
We have proposed a new endoscopic technique that involves using cartilage and bone grafts to support the flaps used for nasal septal perforation repair and reduce the risk of associated complications.
鼻中隔穿孔是指鼻中隔内的缺损，进而导致两个鼻腔之间形成连通。已有多种手术方法用于修复鼻中隔穿孔；然而，这些方法并发症发生率较高。我们旨在介绍一种新的内镜下修复鼻中隔穿孔的技术，该技术可支撑皮瓣，从而用于预防常见并发症。
这是一项前瞻性队列研究，对40例患者进行了全面的临床检查，包括鼻内镜检查，以确定穿孔的详细情况。随后进行计算机断层扫描（CT）和血液检查，以排除肉芽肿性疾病、肿瘤、颅底缺损、息肉等。这项新技术单独使用一块软骨或软骨与骨结合来支撑皮瓣。在评估中，对穿孔大小进行分类，并为每个患者制定治疗方案。
对研究中的患者进行了评估，他们最常见的主诉是结痂。大多数穿孔小于1厘米的患者不需要支撑；大多数穿孔在1 - 2厘米的患者需要软骨支撑，而穿孔在2 - 3厘米的患者需要软骨和骨支撑。
我们提出了一种新的内镜技术，该技术涉及使用软骨和骨移植来支撑用于鼻中隔穿孔修复的皮瓣，并降低相关并发症的风险。
