Tumlin Parker, Kais Amani, Makary Chadi A
Department of Otolaryngology, West Virginia University, Morgantown, WV, United States of America.
Department of Otolaryngology, West Virginia University, Morgantown, WV, United States of America.
Am J Otolaryngol. 2025 Jan-Feb;46(1):104590. doi: 10.1016/j.amjoto.2024.104590. Epub 2024 Dec 21.
The anterior ethmoidal artery (AEA) flap has been demonstrated to be a reliable option for endoscopic repair of symptomatic nasal septal perforations. The use of fresh frozen cadaveric rib cartilage has been described as a safe alternative graft for rhinoplasty procedures.
The aim of this study was to discuss our initial outcomes of use of cadaveric rib cartilage graft in combination with the AEA flap in endoscopic nasal septal perforation repair.
A single institution retrospective case series of all consecutive patients who underwent repair of nasal septal perforation utilizing the AEA flap combined with a cadaveric rib cartilage between December of 2022 to August of 2024 was conducted. Demographics and comorbidities were collected preoperatively. The main outcome of this study was surgical success rate defined as closure of the septal perforation.
Six patients were included. Four out of six patients had previously failed septal perforation repair, and two patients had a concomitant open septorhinoplasty after raising the AEA flap endoscopically. Overall success rate for complete closure was 100 % with mean follow up of 9.5 months (range of 2-22 months). No major or minor direct postoperative adverse events were encountered.
Initial outcomes of use of the endoscopic AEA flap in combination with a cadaveric rib cartilage graft for closure of a nasal septal perforation are promising. Future studies with larger sample sizes and longer follow up time would be useful to verify these outcomes.
筛前动脉（AEA）皮瓣已被证明是内镜修复有症状鼻中隔穿孔的可靠选择。新鲜冷冻尸体肋软骨已被描述为隆鼻手术中一种安全的替代移植物。
本研究的目的是探讨我们在鼻内镜鼻中隔穿孔修复中使用尸体肋软骨移植物联合AEA皮瓣的初步结果。
对2022年12月至2024年8月期间所有连续接受AEA皮瓣联合尸体肋软骨修复鼻中隔穿孔的患者进行单机构回顾性病例系列研究。术前收集人口统计学和合并症信息。本研究的主要结果是手术成功率，定义为鼻中隔穿孔闭合。
纳入6例患者。6例患者中有4例先前鼻中隔穿孔修复失败，2例患者在内镜下掀起AEA皮瓣后同时进行了开放性鼻中隔鼻成形术。完全闭合的总体成功率为100%，平均随访9.5个月（范围2 - 22个月）。未遇到任何严重或轻微的术后直接不良事件。
内镜下AEA皮瓣联合尸体肋软骨移植物用于闭合鼻中隔穿孔的初步结果很有前景。未来进行更大样本量和更长随访时间的研究将有助于验证这些结果。
