Repair of Nasal Septal Perforation by Using Inferior Turbinate Free Graft
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 1, Pages 125-129
AbstractBackground: Perforation of nasal Septum is a situation characterized by loss of cartilaginous,
bony or both structures of the nasal septum with or without the mucoperichondrium and
mucoperiosteum lining. The causes of septal perforations are endonasal surgeries, trauma,
infections, neoplasms, inflammation, or abuse of inhaled drugs. The main symptoms are
epistaxis, crusting, and whistling, but the majority are asymptomatic.
Objective: this study was aimed to assess the effectiveness of inferior turbinate free graft to
close nasal septal perforations.
Patients and Methods: This is a prospective study, consisted of 20 patients. They were 14 males
and 6 females. They had been assessed at the Otolaryngology Department at Al-Diwaniah
Teaching Hospital, Al-Diwaniah city, Iraq, during the period between January 2017 to January
2019, the age ranges from 20-50 years. Inclusion criteria was symptomatic septal perforation,
located at the cartilaginous portion. Exclusion criteria were the presence of underlying infectious,
inflammatory, or malignant diseases. The surgery began with hemitransfixion incisions. The
perichondral flap is usually raised bilaterally, exposing the entire cartilaginous septum, and
refreshing the edge by knife. partial inferior turbinectomy then did. The medial fleshy part of the
turbinate is resected, then thinning of the flap on a slide. The flap grasped by forceps and
applied through the incision so placed between the cartilage and perichondrial flap covering the
defect, then the the perichondrial flap replaced back to its position. incisions sutured, silastic
sheets applied to cover the whole septum, and merocele nasal Packing inserted for
haemostasis. patient discharged and seen again in the next day for removal of Packing and
cleaning. The silastic sheets removed after 8 days. The patients seen twice monthly for followup.
Results: Complete closure of perforation was obtained in 16 patients (80%). Incomplete closure
occurred in 2 patients (10%). Failure of closure (persistent perforation) occurred in 2 patients
(10%). Improvement of nasal symptoms achieved in all patients with complete closure, patients
with incomplete closure did not show significant problems due to the perforation. patients with
persistent perforation had no Improvement in their symptoms.
Conclusion: Inferior turbinate free graft through the endonasal approach, is useful to close small
and medium-sized septal perforations with minimal morbidity and short operative time.
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