Repair of symptomatic nasoseptal perforations using mucosal regeneration technique with interpositional grafts.

Over the past 60 years, many surgical techniques have been developed for the repair of nasoseptal perforations. This study describes a safe and practical technique involving the 5-layer repair of symptomatic nasoseptal perforations without mucosal flaps. The present study involved 23 patients (17 men and 6 women) who had symptomatic nasoseptal perforations in the Otorhinolaryngology and Head Neck Surgery Department of Haseki Research and Training Hospital. Patients were treated using the mucosal regeneration technique. Follow-up examinations were performed at 3 and 6 months postoperatively. The surgery was considered successful if total closure was achieved. Nasal mucosal physiology was also assessed preoperatively and at 3 and 6 months postoperatively by measuring the nasal mucociliary clearance time by means of the saccharin test. The most common etiological factor was former nasal surgery (56.5%), followed by nasal trauma (26%). In 4 patients (17.5%), the perforations were idiopathic. The average preoperative perforation size was 1.74 ± 0.87 cm. Total closure of the perforation was achieved in 21 patients (91.3%), and only 2 patients had subtotal healing. The mean preoperative mucociliary clearance time was 19.3 ± 4.15 minutes, which significantly improved to 12.4 ± 3.53 minutes and 10.1 ± 3.21 minutes at 3 and 6 postoperative months, respectively. Mucosal regeneration technique with interpositional grafts can be used to safely and reliably repair medium-to-large nasoseptal perforations.

Normal range of peak nasal inspiratory flow and its role in nasal septal surgery.

Nasal obstruction can be evaluated by objective and subjective methods. We sought to determine normative peak nasal inspiratory flow meter (PNIF) measurements of a healthy population in Turkey and to investigate the importance of PNIF in surgery for nasal septal deviation as well as to investigate the correlation of PNIF with subjective methods. In a total of 269 patients, 50 patients underwent septoplasty and 219 control subjects were enrolled in the study. Data on preoperative and postoperative PNIF measurements, nasal septal indices, and subjective measurements (visual analogue scale, VAS) were recorded. Mean PNIF value was 137.8 L/min in control subjects. Postoperative PNIF, VAS, and nasal septal index data were statistically significantly higher in the study group as compared with those of preoperative data. We found PNIF, VAS, and nasal septal indices of the control group to be consistent with postoperative data and to be higher than preoperative data of the study group. We identified a normal PNIF range for the healthy Turkish population and we saw that the data were compatible with VAS scores. PNIF seems to be a very effective method in the evaluation of nasal obstruction and in deciding operation.