Repair of Traumatic Nasal Septal Perforation Using Temporalis Fascia and Interpositional Auricular Cartilage Graft, NASSER A. FAGEEH
Abstract
Objectives: To review our experience in the surgical repair of medium size symptomatic posttraumatic nasal septal per-foration using conchal cartilage and temporalis fascia grafts.
Patients and Methods: A retrospective study patients' records-based design was followed. The study was conducted at Asser Central Hospital and Abha Private Hospital. It com-prised the study of medical records of 19 patients (15 males, 4 females) diagnosed and treated for nasal septal perforation between January 2008 and June 2014. Patients who presented with symptomatic post-traumatic nasal septal perforation were included in the study. All other patients, including asymptom-atic patients, patients who had septal perforation less than 1cm or larger than 3cm, patients suspected to have active inflammatory process, drug abuse and patients who were followed-up for less than 6 months were excluded from the study. One surgeon (the researcher) operated all patients and the surgical technique using temporalis fascia and auricular cartilage grafts was used in all patients.
Results: Sixteen (84.21%) patients had septal perforation as a complication of septoplasty procedure and 3 (15.78%) patients following facial trauma. The mean size of the operated perforations was 15.68mm (range 10-25mm). Presenting symptoms included nasal dryness and crusting in 11 (57.89.10%) patients, nasal pain in 10 (52.63%) patients, nasal obstruction in 8 (42.10%) patients and epistaxis in 7 (36.84%) patients. Five (26.31%) patients experienced three or more symptoms. Seventeen (89.47%) had complete closure and 2 (10.53%) had incomplete closure. One (5.26%) patient of those who had incomplete closure remained symptomatic and declined a second trial of surgical repair.
Conclusion: Closure of nasal septal perforations using temporalis fascia with interpositional auricular cartilage graft is very useful and has high successful rate, especially for the medium sized septal perforations.