Nasal Septal Perforation Repair "Perpendicular Plate of Ethmoid Bone With Vomer + Rib Cartilage Were Used"
We performed an open technique, nasal septal hole closure surgery on a patient with an ovoid-shaped, very large septal perforation of traumatic origin, approximately 6x3 cm in size. After the columellar incision was made, the alar cartilages were dissected in the vertical plane. Partially, perpendicular plate of ethmoid bone and vomer bone were removed with the help of scissors and dissector. With the green injector tip, a hole was made in the bone lamella, cartilage grafts were prepared from the rib cartilages and these bone were sutured together with the lamellas. The septum perforation was dissected in the vertical plane. The edges of the perforation were depepithelized. It was placed vertically in the perforation area. It was observed that the mucosal grafts were in contact with the placed bone + cartilage grafts on both sides. Internal silicone splints with cut external protrusions were placed in both nasal cavities. The columellar incision area was sutured. Bleeding control was done and the operation was terminated. It was planned to keep the silicone splints in the nose for at least 3 months. Nasal irrigation with a mixture of rifampicin + distilled serum was recommended to the patient.
Before the surgery, endoscopic nasal exam video:
In the patient I shared with you here, a very large septum perforation was closed. In this procedure, it is unlikely to achieve complete millimetric closure with a single operation. Even some surgeons do not agree to perform this operation. Here, it is aimed to normalize nasal physiology as much as possible and to prevent nasal hyperventilation and related nasal mucosal changes. In the long term, I will share the results of this patient with you.
Below are photos of the endoscopic nasal examination before the operation, showing the nasal septum perforation.
A Septum Hole Bigger Than 6x3 cm Was Closed With A Single Surgery!
The video below belongs to the patient we operated on 3 months ago and shared with you at the top of this page. Silicone splints were taken by the ENT doctor in his own country and the video was sent to us. The hole appears to be completely closed. We are very happy about this situation.
"Hastamız uzak bir yerden, çok zor bir ameliyat için, 6x3 santimetreden daha buyuk nazal septum perforasyonu nedeniyle Amerika'dan Cincinnati den geldi. 3 ay önce açık teknik nazal septum perforasyonu kapatilmasi operasyonu yaptık (Etmoid Kemiğin Perpendikuler Laminası + Vomer + Kaburga Kıkırdağı Kullanıldı), internal silikonlar bugün oradaki kbb uzmanı tarafından çıkarıldı ve bize videosu atıldı. Tam kapanma sağlanmış. Bizi çok mutlu eden bir sonuç. Buradan Amerika daki hastalarımıza selamlar sevgiler gönderiyoruz.
Our patient came from Cincinnati, USA for a very difficult surgery from a distant place due to a nasal septum perforation larger than 6x3 centimeters. We performed an open technique nasal septum perforation closure operation 3 months ago (Perpendicular Plate of Ethmoid Bone With Vomer + Rib Cartilage Were Used), the internal silicones were removed by the ENT specialist there today and the video was sent to us. Complete closure is achieved. A result that makes us very happy. From here, we send greetings and love to our patients in America.
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Similar links >> Nasal Septum Perforation - Definition, Causes, Symptoms, Diagnosis and Treatment / We Performed Extracorporeal Septum Perforation Repairing Surgery!
Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon
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