Ali ÖZDEK, Ömer BAYIR, Yusuf DÜNDAR, Emel ÇADALLI TATAR, Güleser SAYLAM, Mehmet Hakan KORKMAZ

İki taraflı burun içi ilerletme/rotasyon flepleri kullanarak nazal septal perforasyon kapama

Amaç: Bu çalışmada açık teknik septoplasti yoluyla iki taraflı burun içi ilerletme/rotasyon flepleri kullanılarak uygulanan nazal septal perforasyon NSP onarımındaki deneyimimiz sunuldu.Hastalar ve Yöntemler: Ocak 2009 - Şubat 2013 tarihleri arasında kliniğimizde NSP nedeniyle ameliyat edilen 28 ardışık hastanın tıbbi kayıtları retrospektif olarak incelendi. Hastaların demografik özellikleri ve cerrahi bulguları değerlendirildi.Bulgular: Nazal septal perforasyonun en sık nedeni 18 hastada %64 daha önce geçirilmiş nazal septum cerrahisi idi. En sık görülen semptom 21 hastada %75 burun içerisinde kabuklanma idi. Perforasyon çapı 10-30 mm arasında değişmekteydi. Nazal septal perforasyon tamiri ile birlikte aynı zamanda beş hastada septoplasti, üç hastada septorinoplasti uygulandı. Nazoseptal iskeleti desteklemek amacı ile gerekli olduğu durumlarda nazal septal kartilaj ve aurikula konkal kartilaj kullanıldı. Ameliyat sırası ya da sonrası majör komplikasyon ile karşılaşılmadı. Ameliyat sonrası ortalama takip süresi 23 ay idi. Takip sürecinde beş hastada %18 kolumellar retraksiyon görüldü. Nazal septal perforasyon 24 hastada %86 başarı ile kapatıldı. Pinpoint perforasyon iki hastada görülürken, iki hastada perforasyon 5 mm’nin altında idi. Sonuç: İki taraflı burun içi ilerletme/rotasyon flepleri kullanılarak uygulanan NSP kapama kıyaslanabilir düzeyde yüksek başarı oranına sahiptir. Bu nedenle, bu teknik özellikle küçük ve orta çaplı perforasyonlara kolaylıkla uygulanabilir

Anahtar Kelimeler:

Nazal septum, nazal septum perforasyonu, rekonstrüktif cerrahi işlem, cerrahi flep

Closure of nasal septal perforations using bilateral intranasal advancement/rotation flaps

Objectives: This study aims to report our experience on surgical repair of nasal septal perforations NSP using bilateral intranasal advancement/rotation flaps with open septoplasty technique. Patients and Methods: Medical records of 28 consecutive patients who were operated for NSP in our clinic between January 2009 and February 2013 were retrospectively analyzed. Demographic features of the patients and surgical results were evaluated. Results: The most common cause of NSP was previous septal surgery in 18 64% of the patients. Nasal crusting was the most common symptom in 21 patients 75% . Perforation size ranged from 10 to 30 mm in diameter. Septoplasty was performed in five patients, while septorhinoplasty was performed in three patients simultaneously to the NSP repair. Nasal septal cartilage and auricular chonchal cartilage were used to support the nasoseptal skeleton, if required. There were no major intra- or postoperative complications. The mean postoperative follow-up period was 23 months. During follow-up, there was mild columellar retraction in five patients 18% . Nasal septal perforation was closed successfully in 24 patients 86% . Pinpoint perforation remained in two patients and perforation size was smaller than 5 mm in two patients. Conclusion: Closing the NSP with bilateral intranasal advancement/rotation flaps has a comparable high success rate. Therefore, this technique can be easily applied to small-medium sized septal perforations.

Keywords:

Nasal septum, nasal septum perforation, reconstructive surgical procedure, surgical flap,

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