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Septal Deviation Treatment Using Bone or Cartilage Grafts Fixed with Cyanoacrylate Tissue Adhesive

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  • Rhinoplasty
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Abstract

Background

This paper presents a method in which bone or cartilage grafts are fixed to the septal cartilage with cyanoacrylate-based tissue adhesive for the treatment of septal deviation. A prospective study was designed to show the effectiveness of the technique.

Methods

Cyanoacrylate-based tissue adhesive was used to fix the cartilage or bone grafts onto the septal cartilage to straighten deviated septal cartilage in 77 patients. Regarding the patients’ preoperative and postoperative nasal respiration, the following were assessed: (1) Nasal Obstruction Symptom Evaluation (NOSE) scales, (2) patient satisfaction with postoperative nasal respiration using visual analog scoring, and (3) computerized tomographic images.

Results

The patients were followed up for 29 months on average. Patients’ respiration-related problems resulting from septal deviation were relieved in all but four patients. Clinically and radiologically, the straightened septums preserved their new forms, and it was detected with computerized tomography that the bone grafts had acquired permanency. In addition, the NOSE scores improved significantly compared to their preoperative levels.

Conclusions

In cases in which the use of bone or cartilage grafts is chosen to straighten the deviated septal cartilage, fixation of grafts with cyanoacrylate (CA) tissue adhesive is a quick, instantly effective, and reliable method. CA, which enables the subsurface of the graft to have complete contact with the septal cartilage, provides extra benefit by transferring all of the reformative forces of the grafts to the septal cartilage.

Level of Evidence II

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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References

  1. Lopatin AS (1996) Do laws of biomechanics work in reconstruction of the cartilaginous nasal septum? Eur Arch Otorhinolaryngol 253:309–312

    Article  CAS  PubMed  Google Scholar 

  2. Byrd HS, Salomon J, Flood J (1998) Correction of the crooked nose. Plast Reconstr Surg 102:2148–2157

    Article  CAS  PubMed  Google Scholar 

  3. Gunter JP, Rohrich RJ (1988) Management of the deviated nose. The importance of septal reconstruction. Clin Plast Surg 15:43–55

    CAS  PubMed  Google Scholar 

  4. Sedwick JD, Lopez AB, Gajewski BJ, Simons RL (2005) Caudal septoplasty for treatment of septal deviation: aesthetic and functional correction of the nasal base. Arch Facial Plast Surg 7:158–162

    Article  PubMed  Google Scholar 

  5. Tellioglu AT, Oktem F (2008) A surgical algorithm for treatment of septal deviation in secondary cases. Ann Plast Surg 61:601–606

    Article  CAS  PubMed  Google Scholar 

  6. Metzinger SE, Boyce RG, Rigby PL, Joseph JJ, Anderson JR (1994) Ethmoid bone sandwich grafting for caudal septal defects. Arch Otolaryngol Head Neck Surg 120:1121–1125

    Article  CAS  PubMed  Google Scholar 

  7. Toriumi DM (1994) Subtotal reconstruction of the nasal septum: a preliminary report. Laryngoscope 104:906–913

    Article  CAS  PubMed  Google Scholar 

  8. Guyuron B, Uzzo CD, Scull H (1999) A practical classification of septonasal deviation and an effective guide to septal surgery. Plast Reconstr Surg 104:2202–2209

    Article  CAS  PubMed  Google Scholar 

  9. Vuyk HD (2000) A review of practical guidelines for correction of the deviated, asymmetric nose. Rhinology 38:72–78

    CAS  PubMed  Google Scholar 

  10. Haack J, Papel ID (2009) Caudal septal deviation. Otolaryngol Clin N Am 42:427–436

    Article  Google Scholar 

  11. Dyer WK, Kang J (2000) Correction of severe caudal deflections with a cartilage “plating” rigid fixation graft. Arch Otolaryngol Head Neck Surg 126:973–978

    Article  CAS  PubMed  Google Scholar 

  12. Dini GM, Iurk LK, Ferreira MC, Ferreira LM (2011) Grafts for straightening deviated noses. Plast Reconstr Surg 128:529e–537e

    Article  PubMed  Google Scholar 

  13. Karesh JW (1998) Biomaterials in ophthalmic plastic and reconstructive surgery. Curr Opin Ophthalmol 9:66–74

    Article  CAS  PubMed  Google Scholar 

  14. Ronis ML, Harwick JD, Fung R, Dellavecchia M (1984) Review of cyanoacrylate tissue glues with emphasis on their otorhinolaryngological applications. Laryngoscope 94:210–213

    Article  CAS  PubMed  Google Scholar 

  15. Ozyazgan I, Idacı O (2011) A new method that uses cyanoacrylate tissue adhesive to fill scoring incisions in septal cartilage correction. Laryngoscope 121:1164–1172

    Article  PubMed  Google Scholar 

  16. Binmoeller KF, Soehendra N (1999) New haemostatic techniques: histoacryl injection, banding/endoloop ligation and haemoclipping. Baillieres Best Pract Res Clin Gastroenterol 13:85–96

    Article  CAS  PubMed  Google Scholar 

  17. Pollak JS, White RI Jr (2001) The use of cyanoacrylate adhesives in peripheral embolization. J Vasc Interv Radiol 12:907–913

    Article  CAS  PubMed  Google Scholar 

  18. Esposito C, Damiano R, Settimi A, De Marco M, Maglio P, Centonze A (2004) Experience with the use of tissue adhesives in pediatric endoscopic surgery. Surg Endosc 18:290–292

    Article  CAS  PubMed  Google Scholar 

  19. Pursifull NF, Morey AF (2007) Tissue glues and nonsuturing techniques. Curr Opin Urol 17:396–401

    Article  PubMed  Google Scholar 

  20. Chow A, Marshall H, Zacharakis E, Paraskeva P, Purkayastha S (2010) Use of tissue glue for surgical incision closure: a systematic review and meta-analysis of randomized controlled trials. J Am Coll Surg 211:114–125

    Article  PubMed  Google Scholar 

  21. Patel AJ, Price RD (2011) The use of tissue glue in prominent ear correction surgery. Aesthet Plast Surg 35:245–247

    Article  Google Scholar 

  22. Most SP (2006) Anterior septal reconstruction: outcomes after a modified extracorporeal septoplasty technique. Arch Facial Plast Surg 8:202–207

    Article  PubMed  Google Scholar 

  23. Yang JW, Kim SI, Kwon JW, Park DJ (2008) Are cross-hatching incisions mandatory for correction of cartilaginous septal deviation? Clin Exp Otorhinolaryngol 1:20–23

    Article  PubMed  PubMed Central  Google Scholar 

  24. Stewart MG, Witsell DL, Smith TL, Weaver EM, Yueh B, Hannley MT (2004) Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale. Otolaryngol Head Neck Surg 130:157–163

    Article  PubMed  Google Scholar 

  25. Senyuva C, Yücel A, Aydin Y, Okur I, Güzel Z (1997) Extracorporeal septoplasty combined with open rhinoplasty. Aesthet Plast Surg 21:233–239

    Article  CAS  Google Scholar 

  26. Wright WK (1969) Principles of nasal septum reconstruction. Trans Am Acad Ophthalmol Otolaryngol 73:252–255

    CAS  PubMed  Google Scholar 

  27. Min YG, Chung JW (1996) Cartilaginous incisions in septoplasty. ORL J Otorhinolaryngol Relat Spec 58:51–54

    Article  CAS  PubMed  Google Scholar 

  28. Calderón-Cuéllar LT, Trujillo-Hernández B, Vásquez C, Padilla-Acero J, Cisneros-Preciado H (2004) Modified mattress suture technique to correct anterior septal deviation. Plast Reconstr Surg 114(6):1436–1441

    Article  PubMed  Google Scholar 

  29. Gubisch W (2005) Extracorporeal septoplasty for the markedly deviated septum. Arch Facial Plast Surg 7:218–226

    Article  PubMed  Google Scholar 

  30. Boenisch M, Mink A (2000) Clinical and histological results of septoplasty with a resorbable implant. Arch Otolaryngol Head Neck Surg 126:1373–1377

    Article  CAS  PubMed  Google Scholar 

  31. Lawson W, Westreich R (2007) Correction of caudal deflections of the nasal septum with a modified Goldman septoplasty technique: how we do it. Ear Nose Throat J 86:617–620

    PubMed  Google Scholar 

  32. Gerlinger I, Kárász T, Somogyvári K, Szanyi I, Ráth G, Móricz P et al (2007) Extracorporal septal reconstruction with polydioxanone foil. Clin Otolaryngol 32:465–470

    Article  CAS  PubMed  Google Scholar 

  33. James SE, Kelly MH (2008) Cartilage recycling in rhinoplasty: polydioxanone foil as an absorbable biomechanical scaffold. Plast Reconstr Surg 122:254–260

    Article  CAS  PubMed  Google Scholar 

  34. Ellis MS (1980) Suture technique for caudal septal deviations. Laryngoscope 90:1510–1512

    CAS  PubMed  Google Scholar 

  35. Kim BH, Kim JY, Park JS, Kang SH, Lim DJ, Yu MS (2014) Combined use of scoring incisions and 2-octylcyanoacrylate adhesive during endonasal septoplasty to correct cartilaginous deviations. Am J Rhinol Allerg 28:209–213

    Article  Google Scholar 

  36. Karamzadeh AM, Rasouli A, Tanenbaum BS, Milner TE, Nelson JS, Wong BJ (2001) Laser-mediated cartilage reshaping with feedback-controlled cryogen spray cooling: biophysical properties and viability. Lasers Surg Med 28:1–10

    Article  CAS  PubMed  Google Scholar 

  37. Wong BJ, Milner TE, Harrington A, Ro J, Dao X, Sobol EN et al (1999) Feedback-controlled laser-mediated cartilage reshaping. Arch Facial Plast Surg 1:282–287

    Article  CAS  PubMed  Google Scholar 

  38. Brown PN, McGuff HS, Noorily AD (1996) Comparison of N-octyl-cyanoacrylate vs suture in the stabilization of cartilage grafts. Arch Otolaryngol Head Neck Surg 122:873–877

    Article  CAS  PubMed  Google Scholar 

  39. Costa HJ, Pereira CS, Costa MP, Fabri FS, Lancellotti CL, Dolci JE (2007) Experimental comparative study in rabbits of three different ways of cartilage graft fixation: suture, gelatin-resorcin-formaldehyde and butyl-2-cyanoacrylate. Acta Otolaryngol 127:947–951

    Article  CAS  PubMed  Google Scholar 

  40. Quatela VC, Futran ND, Frisina RD (1993) Effects of cyanoacrylate tissue adhesives on cartilage graft viability. Laryngoscope 103:798–803

    Article  CAS  PubMed  Google Scholar 

  41. Fung RQ, Ronis ML, Mohr RM (1985) Use of butyl-2-cyanoacrylate in rabbit auricular cartilage. Arch Otolaryngol 111:459–464

    Article  CAS  PubMed  Google Scholar 

  42. Toriumi DM, Raslan WF, Friedman M, Tardy ME Jr (1991) Variable histotoxicity of histoacryl when used in a subcutaneous site: an experimental study. Laryngoscope 101:339–343

    Article  CAS  PubMed  Google Scholar 

  43. Webster I, West PJ (2002) Adhesives for medical applications. In: Dumitriu S (ed) Polymeric biomaterials. Marcel Dekker, New York, pp 703–737

    Google Scholar 

  44. Moretti Neto RT, Mello I, Moretti AB, Robazza CR, Pereira AA (2008) In vivo qualitative analysis of the biocompatibility of different cyanoacrylate-based adhesives. Braz Oral Res 22:43–47

    Article  PubMed  Google Scholar 

  45. Sachs ME (1985) Enbucrilate as cartilage adhesive in augmentation rhinoplasty. Arch Otolaryngol Head Neck Surg 111:389–393

    Article  CAS  Google Scholar 

  46. Dabb RW, Gaffield JW, Camp LA (2001) Use of cyanoacrylate (super glue) for the fixation and prefabrication of nasal cartilage grafts. Aesthet Surg J 21:328–333

    Article  CAS  PubMed  Google Scholar 

  47. Quinn JV, Osmond MH, Yurack JA, Moir PJ (1995) N-2-butylcyanoacrylate: risk of bacterial contamination with an appraisal of its antimicrobial effects. J Emerg Med 13:581–585

    Article  CAS  PubMed  Google Scholar 

  48. Wilson MA, Mobley SR (2011) Extracorporeal septoplasty: complications and new techniques. Arch Facial Plast Surg 13:85–90

    Article  PubMed  Google Scholar 

  49. Bloom JD, Kaplan SE, Bleier BS, Goldstein SA (2009) Septoplasty complications: avoidance and management. Otolaryngol Clin North Am 42:463–481

    Article  PubMed  Google Scholar 

  50. Georgiou I, Farber N, Mendes D, Winkler E (2008) The role of antibiotics in rhinoplasty and septoplasty: a literature review. Rhinology 46:267–270

    PubMed  Google Scholar 

  51. Lilja M, Mäkitie AA, Anttila VJ, Kuusela P, Pietola M, Hytönen M (2011) Cefuroximeas as a prophylactic preoperative antibiotic in septoplasty. A double blind randomized placebo controlled study. Rhinology 49:58–63

    PubMed  Google Scholar 

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Acknowledgements

The author would like to thank to Serap Baykan and Reyhan Harputluoğlu for completing the questionnaires concerning NOSE and satisfaction with nasal respiration.

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Authors and Affiliations

  1. Department of Plastic, Reconstructive and Esthetic Surgery, Faculty of Medicine, Erciyes University, 38039, Melikgazi, Kayseri, Turkey

    İrfan Özyazgan

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Correspondence to İrfan Özyazgan.

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Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Özyazgan, İ. Septal Deviation Treatment Using Bone or Cartilage Grafts Fixed with Cyanoacrylate Tissue Adhesive. Aesth Plast Surg 41, 618–627 (2017). https://doi.org/10.1007/s00266-017-0836-9

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  • DOI: https://doi.org/10.1007/s00266-017-0836-9

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