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Analysis of patient- and procedure-related risk factors for nasal septal perforations following septoplasty

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Objectives

To assess the possible relationship between various predictive factors (patient or surgery related) and the development of nasal septal perforations (NSP) with the help of a large study group.

Methods

One hundred and forty-three patients were included in the study. The presence of the following factors was evaluated and compared between the NSP and healthy group: types of surgeries, presence of unilateral or bilateral mucosal tears, concomitant inferior turbinate interventions, smoking, accompanying diabetes mellitus (DM) or allergic rhinitis (AR), types of nasal packings, duration of the surgery (minutes), and the experience of the surgeon (senior/junior). Nasal septal deviations were grouped into two: simple cartilage crests at the septum base and other—more complicated—deviations.

Results

NSP was detected in six (4.2%) patients after a mean follow-up of 9.3 ± 3.7 (min: 6 max: 14) months. None of these patients suffered from (AR) or DM. Four of these patients had unilateral and one patient had bilateral mucosal tears during the surgeries. None of the above-mentioned factors—including mucosal tears, type of the deviation or experience of the surgeon—had a significant effect on NSP.

Conclusion

Untreated bilateral corresponding mucosal tears are the main cause of NSP. When immediately repaired, unilateral or bilateral tears do not affect the development of NSP significantly. Patient-related factors such as age, DM, smoking, AR, and procedure-related factors such as duration, the complexity of the septal deviation, type of the nasal packing, and experience of the surgeon also do not have a significant effect on NSP.

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References

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

    Article  Google Scholar 

  2. Kridel RWH (2004) Considerations in the etiology, treatment, and repair of septal perforations. Facial Plast Surg Clin North Am 12:435–450

    Article  Google Scholar 

  3. Kim DW, Egan KK, O’Grady K, Toriumi DM (2005) Biomechanical strength of human nasal septal lining: comparison of the constituent layers. Laryngoscope 115:1451–1453

    Article  Google Scholar 

  4. Belmont JR (1985) An approach to large nasoseptal perforations and attendant deformity. Arch Otolaryngol 111:450–455

    Article  CAS  Google Scholar 

  5. André RF, Lohuis PJFM, Vuyk HD (2006) Nasal septum perforation repair using differently designed, bilateral intranasal flaps, with nonopposing suture lines. J Plast Reconstr Aesthetic Surg 59:829–834

    Article  Google Scholar 

  6. Friedman M, Ibrahim H, Ramakrishnan V (2003) Inferior turbinate flap for repair of nasal septal perforation. Laryngoscope 113:1425–1428

    Article  Google Scholar 

  7. Kim SW, Rhee CS (2012) Nasal septal perforation repair: predictive factors and systematic review of the literature. Curr Opin Otolaryngol Head Neck Surg 20:58–65

    Article  Google Scholar 

  8. Moon IJ, Kim SW, Han DH et al (2011) Predictive factors for the outcome of nasal septal perforation repair. Auris Nasus Larynx 38:52–57

    Article  Google Scholar 

  9. Bousquet J, Khaltaev N, Cruz AA et al (2008) Allergic rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 63:8–160

    Article  Google Scholar 

  10. Dąbrowska-Bień J, Skarżyński PH, Gwizdalska I, Łazęcka K, Skarżyński H (2018) Complications in septoplasty based on a large group of 5639 patients. Eur Arch Otorhinolaryngol 275:1789–1794

    Article  Google Scholar 

  11. Lanier B, Kai G, Marple B, Wall GM (2007) Pathophysiology and progression of nasal septal perforation. Ann Allergy Asthma Immunol 99:473–480

    Article  Google Scholar 

  12. Rettinger G, Kirsche H (2006) Complications in septoplasty. Facial Plast Surg 22:289–297

    Article  CAS  Google Scholar 

  13. Topal O, Celik SB, Erbek S, Erbek SS (2011) Risk of nasal septal perforation following septoplasty in patients with allergic rhinitis. Eur Arch Otorhinolaryngol 268:231–233

    Article  Google Scholar 

  14. Cetiner H, Cavusoglu I, Duzer S (2017) The effect of smoking on perforation development and healing after septoplasty. Am J Rhinol Allergy 31:63–65

    Article  Google Scholar 

  15. Elwany S, Ibrahim AA, Mandour Z, Talaat I (2012) Effect of passive smoking on the ultrastructure of the nasal mucosa in children. Laryngoscope 122:965–969

    Article  Google Scholar 

  16. Luan CW, Tsai MS, Liu CY et al (2020) Increased risk of nasal septal abscess after septoplasty in patients with type 2 diabetes mellitus. Laryngoscope. https://doi.org/10.1002/lary.29336

    Article  PubMed  Google Scholar 

Download references

Funding

The research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, 35170, İzmir, Turkey

    Erdem Eren & Mustafa Koray Balcı

  2. Department of Otorhinolaryngology, Nusaybin State Hospital, Mardin, Turkey

    Akif İşlek

Authors
  1. Erdem Eren
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  2. Mustafa Koray Balcı
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  3. Akif İşlek
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Correspondence to Mustafa Koray Balcı.

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Eren, E., Balcı, M.K. & İşlek, A. Analysis of patient- and procedure-related risk factors for nasal septal perforations following septoplasty. Eur Arch Otorhinolaryngol 279, 1357–1361 (2022). https://doi.org/10.1007/s00405-021-06887-2

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  • DOI: https://doi.org/10.1007/s00405-021-06887-2

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