Background: Nasoseptal perforation repair is a challenging condition with no standard technique for repair recognized. Methods: A case series of consecutive patients who underwent nasoseptal perforation repair with an anterior ethmoidal artery flap was conducted. Demographic data, preoperative features of the perforation and postoperative outcomes were analyzed. Closure rate, complications and persistence of nasal symptoms were documented. Results: Thirty-two patients were included in the study. The average perforation diameter was 1.48 cm (range: 0.4–3 cm). Iatrogenic trauma was the most common cause (56% of patients). Nine cases ended up being idiopathic. The overall closure rate was 81%, but 87.5% when perforation had a 2-cm diameter or less. Of the six failures, 2 were due to flap necrosis and 4 to a residual anterior perforation. Despite the persistence, 2 patients solved their symptoms. One patient underwent revision surgery. Conclusion: The anterior ethmoidal artery flap is a reliable and minimal invasive technique for closure of symptomatic perforations. For defects larger than 2 cm, a lower success rate and additional reconstructive measures should be considered. Objective questionnaires are needed in order to evaluate functional outcomes.

Long Term Outcomes of Nasoseptal Perforation Repair With an Anterior Ethmoidal Artery Flap

Bignami M.;Castelnuovo P.
2022-01-01

Abstract

Background: Nasoseptal perforation repair is a challenging condition with no standard technique for repair recognized. Methods: A case series of consecutive patients who underwent nasoseptal perforation repair with an anterior ethmoidal artery flap was conducted. Demographic data, preoperative features of the perforation and postoperative outcomes were analyzed. Closure rate, complications and persistence of nasal symptoms were documented. Results: Thirty-two patients were included in the study. The average perforation diameter was 1.48 cm (range: 0.4–3 cm). Iatrogenic trauma was the most common cause (56% of patients). Nine cases ended up being idiopathic. The overall closure rate was 81%, but 87.5% when perforation had a 2-cm diameter or less. Of the six failures, 2 were due to flap necrosis and 4 to a residual anterior perforation. Despite the persistence, 2 patients solved their symptoms. One patient underwent revision surgery. Conclusion: The anterior ethmoidal artery flap is a reliable and minimal invasive technique for closure of symptomatic perforations. For defects larger than 2 cm, a lower success rate and additional reconstructive measures should be considered. Objective questionnaires are needed in order to evaluate functional outcomes.
2022
2021
endoscopic endonasal surgery; FESS; flap; rhinology; septal perforation; septal surgery; Arteries; Endoscopy; Humans; Nasal Septum; Treatment Outcome; Nasal Septal Perforation; Reconstructive Surgical Procedures
Zocchi, J.; Russo, F.; Volpi, L.; Elhassan, H. A.; Pietrobon, G.; Arosio, A.; Bignami, M.; Castelnuovo, P.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11383/2132167
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