Retrospective Evaluation of a Novel Nasal Tip Suture Technique.

Nasal tip surgery is a crucial aspect of rhinoplasty in which suture techniques play a significant role. Early suturing techniques focused primarily on repositioning alar cartilage remnants after they had undergone significant resection. The size, contour, and orientation of the medial and lateral crura are primary factors in creating a tip shape. In this review, we retrospectively evaluated obliquely oriented dome sutures with triangular dome resection that was performed in 540 rhinoplasty cases at Yunus Emre Hospital between 2015 and 2020. Dome-defining sutures were placed, and a triangular cartilage resection was performed. Subsequently, oblique sutures were placed to achieve the desired lateral cartilage position. Objective assessment of postoperative results (Objective Rhinoplasty Outcome Score), patient satisfaction assessments, and nasal examinations were conducted. The objective assessments of the esthetic results showed a significant improvement, with a mean score of 3.6, which represents a good to excellent outcome. Most patients were subjectively satisfied with the surgical outcomes of rhinoplasty. No serious complications, such as infection, recurrence of deviation, nasal obstruction, or esthetic problems such as dorsal irregularities, were observed after surgery. Overall, suturing techniques play an important role in determining the nasal tip shape. Our technique is beneficial for maintaining a favorable lateral crural position, leading to improved patient satisfaction.

A Novel Technique for Septal Perforation Repair: Fascia Lata Graft.

BACKGROUND: Nasal septal perforation (NSP) is an anatomical defect involving the mucosa, cartilage/bone of the nasal septum, most commonly caused by septoplasty. Spontaneous healing of a perforated septum is rare; instead, it tends to worsen over time. Several surgical approaches have been described for NSP repair. In this study, the authors present a novel technique using only fascia lata graft for repairing NSP of various sizes. METHODS: The authors conducted a retrospective study, including 23 patients who underwent NSP repair between January 2020 and January 2022. Grafts were harvested, and the perforation was accessed through an open rhinoplasty approach, followed by insertion and suturing of the graft. RESULTS: The mean size of the septal perforations was 2.13 mm horizontally and 2.14 mm vertically. The mean follow-up period was 12 months. Complete closure of NSP was achieved in 21 out of 23 patients (91.30%). Among the cases, 17 were males (11.76%), and the age ranged from 20 to 43 years with a mean of 36.5. Eight cases (50%) were smokers. At 12 months postoperatively, 3 medium-sized NSPs were closed successfully, whereas 2 large NSPs did not achieve closure due to smoking. CONCLUSION: The fascia lata technique for NSP closure is a safe and reliable approach with a high success rate, which should be considered for patients with NSP.

The effect of platelet-rich fibrin (PRF) on wound healing, adhesion, and hemostasis after endoscopic sinus surgery in patients with nasal polyposis.

PURPOSE: Chronic rhinosinusitis (CRS) is one of the most common chronic diseases seen worldwide. Endoscopic sinus surgery (ESS) has become a widely accepted procedure for medically refractory chronic rhinosinusitis and nasal polyps. Prevention of revision surgery often depends on good wound healing and less adhesion formation. In recent years, the effects of platelet-rich fibrin (PRF) on tissue healing have been addressed in many surgical branches, especially for dental implant surgery and plastic surgery. METHODS: This prospective study was conducted with 50 patients who underwent endoscopic sinus surgery for the diagnosis of nasal polyposis. While the middle meatus in one nasal cavity was filled with PRF and supported with Nasopore, only Nasopore was used in the other nasal cavity middle meatus. The patients were followed up clinically at weeks 1, 2, 3, 4, 8, and 12 postoperatively. The assessor determined the presence of adhesion, crusting, bleeding, frontal ostium stenosis, granulation, and infection, and if present, the grades of these complications were scored according to a questionnaire. RESULTS: In our study, adhesion, infection, bleeding, granulation, and frontal ostium stenosis were less common in the PRF group, and a statistically significant difference was found between the groups. CONCLUSION: In our study, better results were obtained in terms of adhesion, infection, bleeding, granulation, and frontal ostium stenosis after ESS as a result of the effects of PRF on wound healing. The application of PRF is an inexpensive and easy procedure. PRF can be a good alternative to other types of tampons after ESS.

Evaluation of the Efficacy of Hilotherapy for Postoperative Edema, Ecchymosis, and Pain After Rhinoplasty.

PURPOSE: Edema and ecchymosis are among the most important morbidities after rhinoplasty. The aim of the present study was to investigate the effects of hilotherapy application compared with traditional ice applications after rhinoplasty in terms of periorbital edema, ecchymosis, and pain. PATIENTS AND METHODS: A total of 60 patients (35 women and 25 men) had undergone primary rhinoplasty with the same surgeon. In the postoperative period, 30 patients in the study group received continuous cooling at 15°C using Hilotherm (Hilotherm GmbH, Argenbühl-Eisenharz, Germany), and 30 patients in the control group were treated with conventional cryotherapy with ice packs. Both treatments started within 45 minutes after the end of the surgery and were maintained for 24 hours. For the following 1 week, the patients were examined for edema, ecchymosis, and pain. RESULTS: When the postoperative periorbital region was evaluated for mean edema and mean ecchymosis for 7 days, less edema and less ecchymosis were detected in the Hilotherm group compared with that observed in the ice pack group (P < .001). When the mean pain scores were compared both morning and evening for 7 days, less pain had been recorded with Hilotherm application compared with ice application (P < .001). CONCLUSIONS: Hilotherapy is a useful method to prevent postoperative edema, ecchymosis, and pain compared with traditional ice application.

Comparison of the Olfactory Functions in Conventional Endoscopic Sinus Surgery to the Balloon Sinuplasty in Frontal Sinus Surgery.

OBJECTIVE: Balloon sinuplasty is being used worldwide, however the olfactory functions after balloon sinuplasty are underestimated. The authors aimed to study the effects of conventional endoscopic sinus surgery (ESS) compared to the balloon sinuplasty on olfactory function. MATERIALS AND METHODS: Forty-four subjects were randomly divided into 2 groups as ESS and balloon sinuplasty. The olfactory functions of each subject were recorded preoperatively and at the 1st, 3rd, 6th, and 12th months postoperatively. RESULTS: The initial assessments of olfaction were the same in both groups. After the surgery, the olfactory functions were significantly better in those of ESS group (P < 0.05). CONCLUSION: The olfactory function is preserved better in the conventional surgery compared to the balloon catheter dilation of the frontal sinus.

Costal Cartilage and Costal Perichondrium Sandwich Graft in Septal Perforation Repair.

BACKGROUND: Repair of the septal perforation is a challenging procedure and there are many different surgical techniques. In this study, the authors present a novel method which the authors use costal cartilage and costal perichondrium sandwich graft as an interposition graft with bilateral opposing mucoperichondrial flaps. PATIENTS AND METHODS: Fourteen patients (5 females, 9 males) underwent septal perforation repair. All surgeries were performed through an open approach septoplasty technique. The edges of the perforation were incised to excise the mucosa with a thickness of 2 mm. Bilateral mucoperichondrial flaps were raised. Then costal cartilage and costal perichondrium were harvested from the rib. The cartilage was divided into a smaller piece which is 2 mm thick and 1 cm wider than perforation size. The prepared cartilage was wrapped with perichondrium to obtain a sandwich graft. This sandwich graft was placed between the mucoperichondrial flaps, corresponding to the perforation. RESULTS: After 9 months of follow-up, 11 (78%) of the 14 perforations were completely closed. Failure of the repair was observed in 3 patients; 2 of the perforations were medium size and one perforation was large size. No complications occurred. CONCLUSION: Using costal cartilage and costal perichondrium sandwich graft is a novel and useful technique especially in large septal perforations. Considering that septum surgery has an important role in the etiology of septum perforation, this method provides a good graft source for both perforation closure and simultaneous rhinoplasty surgery.

Histopathological Comparison of 2-Octyl Cyanoacrylate and Primary Suturing for Tongue Lacerations.

OBJECTIVE: To enable tongue incisions to be repaired more easily, rapidly, and practically, particularly in pediatric patients by using 2-octyl cyanoacrylate (OCA) tissue adhesive. METHODS: A single linear incision was made on the midline dorsal part of the tongue. Twenty-four rats were randomly divided into the four groups: Group 1 (n = 6), OCA healing at day 5; group 2 (n = 6), OCA healing at day 21; group 3 (n = 6), Vicryl healing at day 5; group 4 (n = 6), Vicryl healing at day 21. In groups 1 and 2, OCA was applied to the incision site. The incisions of the rats in groups 3 and 4 were closed using Vicryl sutures. Histopathological examination was compared between and within the groups at day 5 and 21. RESULTS: The operation duration was significantly shorter with OCA than with Vicryl sutures(P < 0.001). Regarding the histopathological results, there were no differences between group 1 and group 3 in epithelial regeneration, inflammation, fibroblastic activity, edema, presence of giant cells, fibrin deposition, ulceration, abscess formation, and granulation tissue. However, moderate infiltration of acute inflammatory cells was significantly more frequent in group 1 than in group 3. At day 5, the incidence of moderate foreign body residue was significantly higher in group 1 than in group 3. No difference was observed between group 2 and group 4 at day 21 (P > 0.05). CONCLUSION: OCA is a practical, rapid, and effective method for repairing tongue lacerations. Although infiltration by inflammatory cells and foreign bodies increased in the early period, the long-term results of OCA were indistinguishable from those of suturing.

Preservation of Autogenous Septal Cartilage for Revision Surgery.

The aim of this study is to find the ideal solution and the optimum temperature to protect the viability of the cartilage graft. This randomized prospective study consists of 30 patients with septal deviation. All patients had septoplasty operation for chronic nasal obstruction. Ten strips of cartilages were prepared from each excised septum and then immersed in formalin, alcohol (96%), saline (0,9%), gentamicin (80 mg), and cefazolin sodium (Cezol 1gr) solutions in a total of 300 vials. Those vials were stored for 6 months at both +4°C and -18°C temperatures. Two groups were compared with each other. 22 cases were male (73%) and 8 patients were female (7%). The age range was between 20 and 48 (average 25.34 ±â€Š4.09 years). Parameters at +4°C; the cartilage volume was not significantly different among the solutions (P >0.05). Necrosis was significantly lower in the alcohol (46.7%) compared to other solutions (P = 0.001). Calcification was lower in the gentamicin group (56.7%). The loss of metachromasia was lower in the alcohol solutions (P = 0.000). Parameters at -18°C; the loss of metachromasia was higher in the gentamicin group (56.7%) than the other solutions (P = 0.003). The authors observed no significance in the rates of necrosis, calcification, metaplasia, inflammation, vascularity, or fibrosis among the solutions (P >0.05). Less necrosis and metachromosis loss in the alcohol solution indicated that alcohol was more suitable for preservation of the cartilage. In addition, temperature degree for the preservation of the cartilage did not show any significant differences.

Camouflage of the Nasal Dorsum in Thin-Skinned Patients with Diced Cartilage Combined with a New Cross-Linked Hyaluronan (NCH) Gel and Blood: A New Method.

INTRODUCTION: Nasal dorsum irregularities after rhinoplasty are still one of the most common complaints among both surgeons and patients. In this study, we used a new cross-linked hyaluronan (NCH) gel and blood mixture as the stabilisation scaffold. Diced cartilage combined with the NCH gel and blood mixture was used for nasal dorsum camouflage. PATIENTS AND METHODS: Fifty-two thin-skinned patients (29 females and 23 males) underwent primary rhinoplasty including nasal dorsum enhancement with diced cartilage combined with the NCH gel and blood mixture. The cartilage tissue was diced into small pieces; then, 1 cc NCH gel and blood were added into diced cartilage. The mixture was delivered onto the nasal dorsum via dorsal retractor. RESULTS: After 1 year of follow-up, there were no irregularities in the nasal dorsum area observed, nor any displacement or absorbance of the camouflage material. No complications occurred. CONCLUSION: The use of diced cartilage combined with the NCH gel and blood is an effective, simple and safe method for nasal dorsum camouflage in thin-skinned patients in rhinoplasty. The NCH gel within the mixed graft also reduces adhesions at the osteotomy lines. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Is There a Relationship Between Snoring Sound Intensity and Frequency and OSAS Severity?

OBJECTIVES: We investigated the relationship between snoring sounds and severity of obstructive sleep apnea syndrome (OSAS). METHODS: A total number of 103 snoring patients (60 males and 43 females) were evaluated by means of polysomnographic findings and snoring sound recordings. Snoring sound intensity was assessed using fast Fourier transform (FFT) method by measuring maximal frequency (Fmax) and average snoring sound intensity level (SSIL). RESULTS: Maximal frequency and SSIL are correlated with apnea-hypopnea index (AHI), REM AHI, and severity of the OSAS. So, as the severity of the OSAS increased, so did the Fmax and SSIL of the snoring recordings, meaning patients started snoring louder with more frequency. In older patients, in females, in severe OSAS group, and in patients with higher body mass index (BMI), AHI and AHI REM values and SSIL and Fmax values increased. As mean oxygen (O2) saturation and lowest O2 saturation decreased, SSIL and Fmax values increased. CONCLUSION: Maximal frequency and SSIL analysis of the snoring sound increased in severe OSAS patients. People should be aware of the importance of snoring sounds. In particular, patients with snoring sounds increasing in intensity and of higher frequency should discuss with their physicians the possibility of OSAS.

Hunger state affects both olfactory abilities and gustatory sensitivity.

Chemical senses such as odor, taste and appearance are directly related with appetite. Understanding the relation between appetite and flavor is getting more important due to increasing number of obese patients worldwide. The literature on the studies investigating the change in olfactory abilities and gustatory sensitivity mostly performed using food-related odors and tastes rather than standardized tests were developed to study olfaction and gustation. Therefore, results are inconsistent and the relationship between olfactory and gustatory sensitivity with respect to the actual state of human satiety is still not completely understood. Here, for the first time in literature, we investigated the change in both olfactory abilities and gustatory sensitivity in hunger and in satiety using 123 subjects (37 men, 86 women; mean age 31.4 years, age range 21-41 years). The standardized Sniffin' Sticks Extended Test and Taste Strips were used for olfactory testing and gustatory sensitivity, respectively. TDI score (range 1-48) was calculated as the collective scores of odor threshold (T), odor discrimination (D) and odor identification (I). The evaluation was performed in two successive days where the hunger state of test subjects was confirmed by blood glucose test strips (mean blood glucose level 90.0 ± 5.6 mg/dl in hunger and 131.4 ± 8.1 mg/dl in satiety). The results indicated statistically significant decrease in olfaction in satiety compared to hunger (mean TDI 39.3 ± 1.1 in hunger, 37.4 ± 1.1 in satiety, p < 0.001). The comparison of gustatory sensitivity indicated significantly higher sensitivity to sweet, sour and salty in hunger (p < 0.001), but significantly higher sensitivity to bitter tastant in satiety (p < 0.001). With this prospective study, we were able to show that both olfactory abilities and gustatory sensitivity were affected by hunger state.

Immunotherapy in all aspects.

Allergen immunotherapy is a form of long-term treatment that decreases symptoms for many people with allergic rhinitis, allergic asthma, conjunctivitis (eye allergy) or stinging insect allergy. In this review, we presented the important topics in immunotherapy. The important aspects of immunotherapy are considered to be "Immunological responses to immunotherapy"; "The principal types of immunotherapy"; "Effectiveness"; "Indications"; "Contraindications"; "Allergen immunotherapy in children"; "Safety"; and "Anaphylactic reactions after immunotherapy". The principal types of immunotherapy are subcutaneous immunotherapy (SCIT) and sublingual immunotherapy. Both of them can be used in indicated cases. When using SCIT, physicians must be more careful because of reported rare fatal cases. The risks and benefits of continuing allergen immunotherapy in patients who have experienced severe systemic reactions should be carefully considered.

Are temporomandibular disorders associated with habitual sleeping body posture or nasal septal deviation?

Numerous factors can be considered for the etiology of temporomandibular disorders (TMD). The aim of the present study was to investigate whether the presence of both nasal septal deviation (NSD) and habitual prone sleeping posture (HPSP) predisposes TMD. We evaluated 200 subjects in 4 groups. Group I (NSD-, HPSP-/control group), Group II (NSD+, HPSP-), Group III (NSD-, HPSP+), Group IV (NSD+, HPSP+). All patients were examined according to the research diagnostic criteria to determine the presence of TMD. Group IV had the highest value for TMD incidence (44 %). Thus, we found that the presence of both NSD and HPSP parameters increased TMD incidence in Group IV compared to the control group (p = 0.000). Additionally, Group IV showed significantly higher values than Group II (p = 0.012) and Group III (p = 0.039). For Group III (NSD-, HPSP+), TMD was determined higher compared to the control group (p = 0.009). A statistically higher value of presence of TMD was determined in Group II (NSD+, HPSP-) than control group (p = 0.029). The incidence of TMD was significantly higher in women than men (p = 0.020). We concluded that one having an unilateral obstructive nasal septal deviation in addition to a habit of sleeping in prone position must be alert for potential TMD.

Effects of nasal continuous positive airway pressure therapy on partners' sexual lives.

To assess sexual functioning in male and female partners before and after nasal continuous positive airway pressure (CPAP) therapy in men with obstructive sleep apnea (OSA). Twenty-one male patients with moderate to severe OSA and erectile dysfunction, and their female partner, were recruited into this prospective study. Males diagnosed with OSA were treated with nasal CPAP therapy for 12 weeks. Women were assessed for sexual functioning using the Female Sexual Function Index (FSFI), and for mood status using the Beck Depression Inventory (BDI), before and after their male partner underwent nasal CPAP therapy. Sexual functioning was assessed in men using the International Index of Erectile Function (IIEF), before and after nasal CPAP therapy. After nasal CPAP therapy for OSA in men, IIEF scores were significantly higher than pre-treatment scores. Total pre- and post-treatment IIEF scores (mean ± standard deviation) were 50.28 ± 15.88 and 65.42 ± 7.47, respectively, P < 0.01. Pre- and post-treatment FSFI scores in women were 21.54 ± 6.62 and 29.94 ± 3.76, respectively, P < 0.01. Pre- and post-treatment BDI scores in women were 14.61 ± 9.69 and 12.42 ± 8.92, respectively, P < 0.01. Following treatment of men with OSA, our data indicate benefits for nasal CPAP therapy on sexual functioning in both the male and female partners. Moreover, our findings indicate that improved sexual function in women after their male partner underwent nasal CPAP also had psychological benefits.

Repair of nasal septal perforation using middle turbinate flap (monopedicled superiory based bone included conchal flap): a new unilateral middle turbinate mucosal flap technique.

UNLABELLED: The purpose of this study is to present a new approach for treatment of nasal septal perforation using middle turbinate flap. A consecutive study with follow-up of 31 patients with nasal septal perforation treated using middle turbinate flap. All patients underwent an endoscopic repair of nasal septal perforation using middle turbinate flap. All patients were followed for 18-24 months. Complete closure of the perforation was achieved in 29 of the 31 patients. Complete failure of the repair was observed in two patients. All patients showed nasal crusting in varying degrees for a period of 2-4 weeks. None of the patients showed nasal obstruction or atrophic rhinitis symptoms (stuffy nose, purulent postnasal drip, nasal crusting, epistaxis and anosmia) in postoperative follow-up. This technique provides a new method with many advantages compared to other techniques for closure of septal perforations. LEVEL OF EVIDENCE: IV.

Rhinorrhoea in the elderly.

The ageing population has various medical problems, ranging from relatively minor to truly severe. The ageing process includes physiological changes that can also aggravate sinonasal problems such as rhinorrhoea. As one of the most troublesome condition of this population, the causes of rhinorrhea can be classified as "age related, medication induced, secondary to rhinitis and other causes (tumour, cerebrospinal fluid (CSF) leakage, etc.)". The underlying aetiology should be meticulously investigated. Although common conditions such as "allergic or infectious rhinitis" are relatively easy to diagnose and threat, more serious causes such as "primary spontaneous CSF rhinorrhea" are hard to manage. The treatment options should be individualised to the patient according to his or her metabolic, cardiac and central nervous system status. Rapid and accurate diagnosis and treatment of the pathology would not only increase the quality of life but also decrease morbidity and mortality of this population. As a conclusion, rhinorrhoea in the elderly is an important condition that should not be overlooked.

Importance of yawning in the evaluation of excessive daytime sleepiness: a prospective clinical study.

As a dark and not fully understood side of human nature, yawning is believed to be a signs of various physiological or pathological behaviors of human. In this study, we aimed to investigate the importance of yawning in the evaluation of sleepiness. One hundred and twenty-nine snorers who were suspected to have obstructive sleep apnea syndrome underwent polysomnography and were asked to fill the Epworth sleepiness scale. The number of yawnings of patients was counted during the day following polysomnography. Patients were stratified into two groups: those have apnea hypopnea index <5 (n = 43, group 1) and those have apnea hypopnea index >30 (n = 86, group 2). Mean duration of sleep phases, oxygen saturations, sleep efficacies, yawning frequencies and Epworth scores of the groups were compared. Correlations of yawning frequency with Epworth scores, duration of sleep phases and mean oxygen saturations were investigated. Sleep efficacies were similar between the groups (p > 0.05). Yawning frequencies in group 1 and group 2 were 43.48 and 75.76 (mean rank), respectively (p < 0.01). Mean N1, N2, N3 phase durations and oxygen saturations were significantly lower in group 2 (p < 0.01). While there was a negative correlation between yawning frequency and duration of the non-REM phases and mean oxygen saturation (r = -0.53 and r = -0.31, respectively, p < 0.05), yawning frequency was positively correlated with Epworth scores (r = 0.46, p < 0.05). In addition to the shortened phases of sleep, increased Epworth score and decreased oxygen saturation, increased yawning frequency may indicate sleep deprivation.

Telephonic analysis of the snoring sound spectrum.

OBJECTIVE: Snoring is a sound caused by vibration of collapsed and/or unsteady airway walls of the pharynx and soft palate. We compared stored spectra of snoring sounds recorded via cell phone (CP) and a microphone placed over the head (head phone [HP]). METHODS: Thirty-four snoring patients were included in this prospective study. Groups were identified by reference to body mass index (BMI) values: group 1, BMI < 25 kg/m² (n = 8); group 2, BMI 25 to 29 kg/m² (n = 10); and group 3, BMI ≥ 30 kg/m² (n = 16). Snoring sounds were recorded using CPs and HPs and digitally analyzed. We identified the frequencies with the highest snoring powers (F(max) values) and snoring sound intensity levels (SSILs). RESULTS: F(max) ranged from 520 to 985 Hz in HP recordings and from 845 to 1645 Hz in CP recordings. Snoring sound intensity level values increased in proportion to BMI and were 6 to 24 dB in HP recordings and 19 to 52 dB in CP recordings. Thus, the CP values of F(max) and SSIL were higher than the HP values. In obese patients of group 3, almost all F(max) and SSIL values were higher than those of groups 1 and 2. In particular, the CP F(max) values were elevated in such patients. The advanced technologies used in modern CPs may allow some snoring sounds in susceptible individuals to be defined as oronasal. CONCLUSION: Cell phone technology allows snoring to be evaluated in patients located in areas remote from a hospital. To explore the intensity of snoring and to postoperatively monitor the efficacy of surgery used to treat snoring, telephonic sound analysis is both new and effective and reduces the need for patient attendance at a hospital. Those experiencing severe snoring and/or who are obese should be told of what can be done to solve such problems.

Effects of lateral osteotomy on nasal sound intensity levels in patients who underwent rhinoplasty.

We investigated the effects of lateral osteotomy on nasal sound intensity levels in 34 patients who underwent rhinoplasty. Four groups were evaluated: group 1, preoperative rhinoplasty with lateral osteotomy (Preop-RPwithLO); group 2, postoperative rhinoplasty with lateral osteotomy (Postop-RPwithLO); group 3, preoperative rhinoplasty without lateral osteotomy (Preop-RPwithoutLO); and group 4, postoperative rhinoplasty without lateral osteotomy (Postop-RPwithoutLO). By sound analysis, low-frequency (Lf; 500-1000 Hz), medium-frequency (Mf; 1-2 kHz), and high-frequency (Hf; 2-4 and 4-6 kHz) nasal sound intensities were defined. Mf-left values of Postop-RPwithLO were significantly lower than those of Preop-RPwithLO, and Mf-left values of Postop-RPwithoutLO were significantly higher than those of Postop-RPwithLO and Preop-RPwithoutLO. Hf-right values of Preop-RPwithoutLO were significantly higher than those of Postop-RPwithLO and Postop-RPwithoutLO. Hf-total values of Postop-RPwithoutLO were significantly lower than those of Preop-RPwithoutLO. Nasal airway width decreased and nasal sounds, especially Mf sound intensities, increased in the nonlateral osteotomy group (group 4). When lateral osteotomy is performed, the nasal air passage may be adjusted as required by the surgeon, the air passage in the nasal valve region may not be narrowed, and nasal sound intensities may decrease. During postoperative follow-ups, increased Mf and Lf nasal sound intensities should be considered for the narrowness of the nasal passage and lower patency of the nasal cavities. Nasal sound analysis is a noninvasive technique and can also be used to evaluate nasal patency in septoplasty and rhinoplasty patients and children and for cases in which official reports are needed in addition to acoustic rhinometry measurements.

Fascia Lata-Fat Island Graft in Septal Perforation Repair.

Objective: To measure the success of the fascia lata-fat island graft technique in septal perforation repair as measured by nasal endoscopic examination. Background: This study presents the results of using fascia lata-fat island, a different graft technique, for the repair of septal perforations, offering an alternative to this challenging procedure. Methods: This retrospective study assesses nasal septal perforation repair using the fascia lata-fat island graft technique performed by a single surgeon. Inclusion criteria involved completing 12-month follow-ups within a 3-year review period. Success rates were calculated and evaluated alongside patient characteristics. Results: The median (range) age of the 25 patients included in the study was 34 (25-45) years and 72.0% were men. The septal perforation size of all patients was >2 cm and the etiological cause in all of them was previous septal surgery. All patients were followed for 12 months. The perforation was completely closed in 23 of 25 patients (92%). Conclusion: Using a different graft with an open rhinoplasty approach, we achieved a high success rate in patients with large septal perforations, followed for 1 month with nasal stenting and an average follow-up duration of 12 months.