ABSTRACT: Repair of nasal septal perforations is one of the most challenging procedures in nasal surgery. The aim of this prospective clinical study was to determine the efficacy of using an inferior turbinate composite graft (ITCG) for the repair of nasal septal perforation.
Between 2009 and 2011, 27 consecutive patients with nasal septal perforation underwent endoscopy-assisted, endonasal septal perforation repair by using an ITCG alone or in combination with bipedicled mucosal advancement flap.
Complete closure of the perforation was achieved in 24 of 27 (88.8%) patients, and incomplete closure was observed in 2 patients with medium-sized perforation and 1 patient with large perforation.
The ITCG technique provides three-layer repair of the defect under no tension in closure of small perforations located anteriorly, posterior perforations with mucosal atrophy, or previous unsuccessful surgical repair. In graft-depleted revision rhinoplasty cases with small-sized septal perforations, this technique provides a simple solution with autogenous grafts. In cases involving larger perforations, the ITCG technique can easily be combined with bipedicled flap and allows for more options to solve a challenging problem. Current data from this prospective study suggest that this surgical technique may be used in the repair of nasal septal perforation.
American Journal of Rhinology and Allergy 05/2012; 26(3):237-42.
ABSTRACT: The aim of our study was to investigate the effect of the topical use of mitomycin C (MMC) intraoperatively in single dose and intra-postoperatively in two doses on the narrowing of antrostomy in maxillary rabbit sinus antrostomies created experimentally. And also to determine the local and systemic side effects of topical MMC. With this objective, 0.6 mg/ml MMC was used to the first group at single dose and to the second group intraoperatively and on third day postoperatively in two doses topically for 5 min. After 8 weeks, although the mean area of antrostomy was larger than that in the control side in the first group, which received single dose MMC, the difference was not statistically significant (p = 0.287). The second group received two doses, and the antrostomy areas were found to be significantly larger than the controls (p = 0.05). Overall, the sides that received MMC were significantly larger (p = 0.029). From the point of histopathological examination of the tissue, it was seen that two-dose MMC increased the edema indicating inflammation and antrostomy resolved with normal respiratory tract epithelium. It was shown by measuring the blood values that nephrotoxic and myelosupressant effect of MMC occurring in systemic use did not occur with single or double dose topical use. Our results demonstrate that even if the number of cases was low, two doses of topical MMC usage prevent the narrowing of antrostomy while single dose MMC does not. And two-dose topical MMC usage does not have local and systemic side effects.
Archives of Oto-Rhino-Laryngology 06/2011; 268(11):1597-603. · 1.29 Impact Factor
ABSTRACT: The aim of this study was to determine the efficacy of a novel method for internal nasal valve reconstruction that enables lateralization of the superior segment of upper lateral cartilages (ULC) from the septum to a greater extent than the spreader graft method with lateral wall support.
Prospective, controlled study set at a tertiary medical center.
The study group was composed of 19 consecutive patients with pure internal nasal valve dysfunction who underwent surgery with the presented technique. All patients completed the Nasal Obstruction Symptom Evaluation (NOSE) and Rhinoplasty Outcomes Evaluation (ROE) tests preoperatively and at 12th month postoperative control to compare functional and aesthetic outcomes.
Based upon pre- and postoperative calculations made using NOSE scores, there was significant improvement regarding nasal blockage or congestion, troubled breathing and sleeping, and air through nose during exercise, respectively (P < .05). There were no aesthetic changes encountered by the patient when pre- and postoperative ROE scores were compared (P > .05).
The H shape of the graft not only improves the graft stability on dorsal septum but also has the advantage of combining the spreader and the splay effects. Current data from this prospective study suggest that this technique may be used in the surgical treatment of internal nasal valve dysfunction.
The Laryngoscope 03/2011; 121(3):480-6. · 1.75 Impact Factor