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Reconstruction for Large Septal Perforations

Reconstruction for Large Septal Perforations Abstract • Reconstruction of large nasoseptal perforations is often dismissed as surgically unfeasible. The insertion of polymer prostheses for amelioration of symptoms has substituted for surgical repair. Despite the important progress that has recently been made, troublesome defects, eg, the repair of 2 × 4-cm losses, are considered surgically unapproachable. One of us (M.S.K.), during the past seven years, has treated these defects with techniques developed in skull base surgery and, more recently, in maxillofacial and craniofacial surgery. The wide exposure achieved has permitted the use of large intranasal flaps for one-step repair. Photographs, graphic illustrations, and cadaver dissections are used to present the techniques. The literature is reviewed. Clinical material is reviewed, and special consideration is given to the problems of intranasal scarring and flap blood supply. The techniques used represent an evolutionary synthesis and implementation of surgical principles rather than a new technique. Nevertheless, the tools are now at hand for all to approach these large perforations with confidence. (Arch Otolaryngol 1982;108:433-436) References 1. Cottle M: Nasal atrophy, atrophic rhinitis, ozena, medical and surgical treatment: Repair of septal perforations . J Int Coll Surg 1958;29:472-484. 2. Denecke H, Meyer R: Plastic Surgery of the Head and Neck , ed 1. New York, Springer Publishing Co Inc, 1967. 3. Fairbanks DNF, Chen SC: Closure of large nasal septum perforations . Arch Otolaryngol 1970;91:403-406.Crossref 4. Fairbanks DNF, Fairbanks GR: Surgical management of large nasal septum perforations . Br J Plast Surg 1971;24:382-387.Crossref 5. Fairbanks DNF: Closure of nasal septal perforations . Arch Otolaryngol 1980;106:509-513.Crossref 6. Tardy ME: Septal perforations . Otolaryngol Clin North Am 1973;6:711-713. 7. Brain DJ: Septorhinoplasty: The closure of septal perforations . J Laryngol Otol 1980;94:495-505.Crossref 8. Strelzow VV, Goodman WS: Nasoseptal perforation-closure by external rhinoplasty . J Otolaryngol 1978;7:43-48. 9. Johnson NE: Septal perforations and secondary septal surgery . Laryngoscope 1968;78:586-599.Crossref 10. Climo S: The surgical closure of a large anterior perforation of the nasal septum . Plast Reconstr Surg 1956;17:410-413.Crossref 11. Gollom J: Perforation of the nasal septum: The reverse flap technique . Arch Otolaryngol 1968;88:518-522.Crossref 12. Tipton JB: Closure of large septal perforations with a labial buccal flap . Plast Reconstr Surg 1970;46:514-515.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology American Medical Association

Reconstruction for Large Septal Perforations

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9977
DOI
10.1001/archotol.1982.00790550037009
Publisher site
See Article on Publisher Site

Abstract

Abstract • Reconstruction of large nasoseptal perforations is often dismissed as surgically unfeasible. The insertion of polymer prostheses for amelioration of symptoms has substituted for surgical repair. Despite the important progress that has recently been made, troublesome defects, eg, the repair of 2 × 4-cm losses, are considered surgically unapproachable. One of us (M.S.K.), during the past seven years, has treated these defects with techniques developed in skull base surgery and, more recently, in maxillofacial and craniofacial surgery. The wide exposure achieved has permitted the use of large intranasal flaps for one-step repair. Photographs, graphic illustrations, and cadaver dissections are used to present the techniques. The literature is reviewed. Clinical material is reviewed, and special consideration is given to the problems of intranasal scarring and flap blood supply. The techniques used represent an evolutionary synthesis and implementation of surgical principles rather than a new technique. Nevertheless, the tools are now at hand for all to approach these large perforations with confidence. (Arch Otolaryngol 1982;108:433-436) References 1. Cottle M: Nasal atrophy, atrophic rhinitis, ozena, medical and surgical treatment: Repair of septal perforations . J Int Coll Surg 1958;29:472-484. 2. Denecke H, Meyer R: Plastic Surgery of the Head and Neck , ed 1. New York, Springer Publishing Co Inc, 1967. 3. Fairbanks DNF, Chen SC: Closure of large nasal septum perforations . Arch Otolaryngol 1970;91:403-406.Crossref 4. Fairbanks DNF, Fairbanks GR: Surgical management of large nasal septum perforations . Br J Plast Surg 1971;24:382-387.Crossref 5. Fairbanks DNF: Closure of nasal septal perforations . Arch Otolaryngol 1980;106:509-513.Crossref 6. Tardy ME: Septal perforations . Otolaryngol Clin North Am 1973;6:711-713. 7. Brain DJ: Septorhinoplasty: The closure of septal perforations . J Laryngol Otol 1980;94:495-505.Crossref 8. Strelzow VV, Goodman WS: Nasoseptal perforation-closure by external rhinoplasty . J Otolaryngol 1978;7:43-48. 9. Johnson NE: Septal perforations and secondary septal surgery . Laryngoscope 1968;78:586-599.Crossref 10. Climo S: The surgical closure of a large anterior perforation of the nasal septum . Plast Reconstr Surg 1956;17:410-413.Crossref 11. Gollom J: Perforation of the nasal septum: The reverse flap technique . Arch Otolaryngol 1968;88:518-522.Crossref 12. Tipton JB: Closure of large septal perforations with a labial buccal flap . Plast Reconstr Surg 1970;46:514-515.Crossref

Journal

Archives of OtolaryngologyAmerican Medical Association

Published: Jul 1, 1982

References