|Beitragstitel||Septal Perforation Repair with Rotation Flaps and interposition of porcine collagen matrix, a Case Series|
Septal Perforations may be asymptomatic or cause patients may complain of nasal obstruction, crusting, bleeding, whistling and in severe cases change in nasal shape and even pain.
The author would like to present a case series of septal perforation repairs using an endo-nasal mucosal rotation flap technique with interposition of porcine collagen matrix. There was one operating surgeon and and 1 year follow up was attempted in all cases. Cases were classified by septal perforation size and primary outcome was an intact septum post operatively.
56 Cases were collected and grouped according to the maximum diameter of the septal perforation at time of surgery. 3 patients needed a revision procedure to achieve successful closure of the nasal septum. 11 were lost to follow up. Asymptomatic recurrent pinhole perforations were also recorded as a failure. Patients were often asymptomatic, even if there was a small recurrent perforation.
Perforation size Successful closure: Asymptomatic:
Group 1 - 0-1cm n = 16 69% 81%
Group 2 - 1-1.9 cm n = 14 71% 86%
Group 3 - 2-2.9 cm n = 10 80% 90%
Group 4 - 3-3.9 cm n = 2 0% 50%
Group 5 - + 4cm n = 3 0% 33%
The use of rotation flaps with porcine collagen matrix is a reliable method of Septal perforation repair with comparable results to other published techniques. There is no external scar so patient acceptance is high. Results are remarkably consistent at around 69-80% success up to a diameter of 3cm. Over 3 cm no perforation was successfully closed, although patients were symptomatically improved.