Endoscopic Repair Of Nasal Septal Perforation With A New Biomaterial And Temp oralis Fascia Graft
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Nasal Septal perforations present a distinct challenge to the otolaryngologist and a significant cause of symptoms to affected patients. Many surgical techniques for the repair of septal perforations have been described. The variety of techniques is evidence that no single technique is recognized as being uniformly reliable in closing all perforations. Connective tissue autografts are commonly used as interpositional grafts between the septa!flaps. The vascular support to the grafts is very important in successful repair of septal perforations. In total, 10 patients (4 women and 6 men, with a median age of 34 years) with symptomatic anterior nasal septal perforations that had failed conservative treatment underwent a closed endoscopic repair of their perforations using the combination of a temporalis fascia graft and extensive mobilization of local mucosal flaps to obtain mucosal closure on at least one side and application of a new bio material, the natural latex membrane with polylysin on the other side. This material is proved to stimulate new vascularization and epithelialization in different parts and tissues of the human body. This material does not cause allergic reaction and it is not rejected by the human tissues. 8 patients had a successful closure of their perforations, one patient, despite initial success, re-perforated as a result of persistent crust picking and in another patient, the graft failed. This result offers a success rate comparable to or better than many techniques suggesting that this new biomaterial, the natural latex membrane with polylysin is a promising material and can be used as a temporary implant, stimulating the vascularization well during tissue repair of septa! perforations. With appropriate patient selection and stringent postoperative care the author considers this technique offers a good surgical outcome for the closure of septa! perforations.