Interposition Technique for Septal Perforation Using a Composite Graft Made Up of Allograft Dermal Matrix and Autologous Cartilage
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background and Objectives Interposition using acellular allograft between perforated septalflaps is a popular procedure among surgeons because of its usefulness. However, allograftdermal matrix itself tends to become infected sometimes, and can easily undergo necrosis or bedisplaced from the implanted site. Here, the authors would like to introduce a newly devisedinterposition graft made up of allograft and cartilage, which is easy to manipulate and can befixed in the desired position. Subjects and Method We performed a retrospective chart review from January 2018 toAugust 2020. A total of 12 patients with septal perforation who received surgical treatmentwere included in this study. Acellular human dermal allograft (MegaDerm®; L&C Bio) wasused as an interposition allograft piled up by autologous cartilage, and it was positioned betweenthe mucoperichondrial flaps via the endonasal approach. Results The most common etiology was previous septal surgery (n=8); in one case, the etiologywas repeated electrocauterization due to frequent epistaxis; the etiology was not verifiedfor three cases. All 12 cases achieved the result of complete septal perforation closure. All patientson follow-up inquiry reported marked improvements in the visual analogue scale score(mean value, 4.1 to 1) and Nasal Obstruction Symptom Evaluation scale (mean value, 7.3 to 1.8). Conclusion Composite graft made up of cartilage and allograft dermal matrix achieved successfulresults without having to fix the graft. It can be an alternative technique to treat septalperforation for inexperienced surgeons and with a limited operation field.
Abstract
Background and Objectives Interposition using acellular allograft between perforated septalflaps is a popular procedure among surgeons because of its usefulness. However, allograftdermal matrix itself tends to become infected sometimes, and can easily undergo necrosis or bedisplaced from the implanted site. Here, the authors would like to introduce a newly devisedinterposition graft made up of allograft and cartilage, which is easy to manipulate and can befixed in the desired position. Subjects and Method We performed a retrospective chart review from January 2018 toAugust 2020. A total of 12 patients with septal perforation who received surgical treatmentwere included in this study. Acellular human dermal allograft (MegaDerm®; L&C Bio) wasused as an interposition allograft piled up by autologous cartilage, and it was positioned betweenthe mucoperichondrial flaps via the endonasal approach. Results The most common etiology was previous septal surgery (n=8); in one case, the etiologywas repeated electrocauterization due to frequent epistaxis; the etiology was not verifiedfor three cases. All 12 cases achieved the result of complete septal perforation closure. All patientson follow-up inquiry reported marked improvements in the visual analogue scale score(mean value, 4.1 to 1) and Nasal Obstruction Symptom Evaluation scale (mean value, 7.3 to 1.8). Conclusion Composite graft made up of cartilage and allograft dermal matrix achieved successfulresults without having to fix the graft. It can be an alternative technique to treat septalperforation for inexperienced surgeons and with a limited operation field.
참고문헌 (21)
- Downs BW, "Septal Perforation" (2021), StatPearls
- Schultz-Coulon HJ, "Nasal septum repair-plasty with pedicled flap technique in 126 patients--an analysis", Laryngorhinootologie, 76(8), pp.466~474 (1997)
- Osma U, "The results of septal button insertion in the management of nasal septal perforation", J Laryngol Otol, 113(9), pp.823~824 (1999)
- Eliachar I, "Improved nasal septal prosthetic button", Otolaryngol Head Neck Surg, 112(2), pp.347~349 (1995)
- Teichgraeber JF, "The management of septal perforations", Plast Reconstr Surg, 91(2), pp.229~235 (1993)
- Kim HC, "Columellar incision scars in Asian patients undergoing open rhinoplasty", JAMA Facial Plast Surg, 18(3), pp.188~193 (2003)
- Kridel RW, "Considerations in the etiology, treatment, and repair of septal perforations", Facial Plast Surg Clin North Am, 12(4), pp.435~450 (2004)
- Nayak JV, "Porcine small intestine submucosal grafts improve remucosalization and progenitor cell recruitment to sites of upper airway tissue remodeling", Int Forum Allergy Rhinol, 8(10), pp.1162~1168 (2018)
- Epprecht L, "Closure of nasal septal perforations with a polydioxanone plate and temporoparietal fascia in a closed approach", Am J Rhinol Allergy, 31(3), pp.190~195 (2017)
- Fairbanks DN, "Closure of nasal septal perforations", Arch Otolaryngol, 106(8), pp.509~513 (1980)
- Kridel RW, "Septal perforation closure utilizing the external septorhinoplasty approach", Arch Otolaryngol Head Neck Surg, 112(2), pp.168~172 (1986)
- Woolford TJ, "Repair of nasal septal perforations using local mucosal flaps and a composite cartilage graft", J Laryngol Otol, 115(1), pp.22~25 (2001)
- Kridel RW, "Septal perforation repair with acellular human dermal allograft", Arch Otolaryngol Head Neck Surg, 124(1), pp.73~78 (1998)
- Ayshford CA, "Endoscopic repair of nasal septal perforation with acellular human dermal allograft and an inferior turbinate flap", Clin Otolaryngol Allied Sci, 28(1), pp.29~33 (2003)
- 이경철, "Surgical Treatment Using an Allograft Dermal Matrix for Nasal Septal Perforation", Yonsei Medical Journal, 49(2), pp.244~248 (2008), 연세대학교의과대학
- 배소영, "Alloderm 삽입이식을 통해 치유한 비강 내 자석에 의한 비중격 천공 1예", 대한이비인후-두경부외과학회지, 52(3), pp.262~265 (2009), 대한이비인후과학회
- Parry JR, "The use of fibrin glue for fixation of acellular human dermal allograft in septal perforation repair", Am J Otolaryngol, 29(6), pp.417~422 (2008)
- Erkan AN, "Effects of fibrin glue on nasal septal tissues", Laryngoscope, 117(3), pp.491~496 (2007)
- Morse J, "Outcomes of nasal septal perforation repair using combined temporoparietal fascia graft and polydioxanone plate construct", JAMA Facial Plast Surg, 21(4), pp.319~326 (2019)
- Sand JP, "Septal perforation repair using polydioxanone plates : A 10-year comparative study", Plast Reconstr Surg, 136(4), pp.700~703 (2015)
- Boenisch M, "Influence of polydioxanone foil on growing septal cartilage after surgery in an animal model : New aspects of cartilage healing and regeneration(preliminary results)", Arch Facial Plast Surg, 5(4), pp.316~319 (2003)