We Performed Again Nasal Valve Surgery + Septum Perforation Repairing Operation

Nasal Valve and Nasal Septal Perforation Closure Surgery

nasal septum perforation, closuse of nasal septal hole, open technique nasal valve surgery,Nasal Valve Collapse Treatment,Alar collapse,

The patient is admitted tto my clinic with comliants of "nasal blockage, whistling sound when breathing through the nose, nasal dryness, nose bleeding, collapse of the nasal wings during breathing". During the exam we found that "the nasal tip is deviated to the left, the nasal bone is deviated to the right, the nasal septum is deviated to the right. There is a perforation of approximately 5 mm in diameter near the anterior part of the nasal septum. There are dry, crusty and bleeding areas on the mucosa at the edge of the perforation. There is nasal valve stenosis, which is more prominent on the left, and nasal valve collapse, which increases while breathing. The Cottle's Maneuver (CM) is positive on both sides. The right inferior turbinate is hypertrophied". Preoperative diagnosis was made as "Nasal septum septum perforation, nasal valve collapse, nasal septum deviation, turbinate hypertrophy". In his past history, he emphasized that after the previous nose operation at the another clinic, most of his complaints emerged. 

Open technique nasal valve surgery + septum perforation repairing surgery + septoplasty +
turbinate radiofrequency reducing operations are planned.

nasal septum perforation, closuse of nasal septal hole, open technique nasal valve surgery,Nasal Valve Collapse Treatment,Alar collapse,

nasal septum perforation, closuse of nasal septal hole, open technique nasal valve surgery,Nasal Valve Collapse Treatment,Alar collapse,

nasal septum perforation, closuse of nasal septal hole, open technique nasal valve surgery,Nasal Valve Collapse Treatment,Alar collapse,

nasal septum perforation, closuse of nasal septal hole, open technique nasal valve surgery,Nasal Valve Collapse Treatment,Alar collapse,



Surgical details: Under general anesthesia, after local anesthesic injection, midcolumellar incision is made. Bilavel skin dissection is performed and underskin tissue is removed from spuratip area. Vertically ssubmucosal dissection is started on the septum, perforation edges resected. Deviated septal cartilage areas is resected after the elevation of mucoperichondriums. 1.5x2 cm cartilage graft is placed vertically on perforation area. 5/0 rapid vicry is used to stitching of muocsa and cartilage. Left side hole mucosal edges are stitched again for making closer. Rigt sided uderskin tisse is places on outside of perforation area (overlay), it stitched again with 5/0 rapid vicryl. Left and right alar cartilage domes are seen as at different positions, lateral and medial cruras were also different lenght. Alar dome stitching is performed. Bilateral spreader graft is prepared.They stitched to between the upper lateral cartilage and upper part of septum with 4/0 PDS suture. Bilateral marginal rim graft is prepared from cadaveric rib cartilage. Both sided stitched with 6/0 vicryl. Left wide alar batten graft and right sided thin alar batten graft is prepared from cadaveric rib cartilage. Strut graft is prepared from rest septal cartilage and inserted between alar cartilages medial cruras. Strut graft sutured with 5/0 PDS suture and 4/0 vicryl sutures. Cap graft is praperad and stiched on alar dom area with 5/0 PDS stitche. Bilaterally, alar cartilage medical cruras lower parts are trimmed with making of additional incisions on columalle side areas. Bilaterally inferior turbinate radifrequency is performed with Celon RadifrequencyProbe II. Internal silicone splints inserted in both anterior nasal cavities and the stiched with 4/0 PDS suture. External bandages is made with 5 mm SteriStrip. External thermoplastic splint is placed. Bleeding is checked. Operation is finished.

9 days after the operation, right nasal cavity, endoscopic nasal examination photographs on the above show that the septum perforation is completely closed and the nasal septum is straight in the midline

9 days after the operation, left nasal cavity, endoscopic nasal examination photographs on the above show that the septum perforation is completely closed and the nasal septum is straight in the midline


Source links >> 

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon

Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
E-Mail: muratenoz@gmail.com 
Mobile phone: +90 533 6550199
Fax: +90 212 542 74 47



  
 


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