J Rhinol.  2018 May;25(1):21-25. 10.18787/jr.2018.25.1.21.

A Securing Suture Technique of Autologous Cartilage for the Prevention of Septal Perforation during Septal Surgery

• Oh DH
• Kang M
• Lee JH

• KMID: 2412916
• DOI: http://doi.org/10.18787/jr.2018.25.1.21

Abstract

BACKGROUND AND OBJECTIVES
Septoplasty is a commonly performed operation in otolaryngological practice. In cases of septal mucosal tearing, septal perforation can easily occur. The aim of this study was to investigate patients who underwent an autologous cartilage securing suture technique to prevent nasal septal perforation.
SUBJECTS AND METHODS
A total of 403 patients who underwent septoplasty alone or with endoscopic sinus surgery for the past three years were enrolled in this study. Septal mucosal tearing occurred in 27 patients. In group 1 (15 patients), autologous cartilage was inserted between the injured mucosa. In group 2 (12 patients), autologous cartilage was inserted between the injured mucosa with a securing suture technique. We investigated the septal perforation rate between the two groups.
RESULTS
In group 1, septal perforation occurred in 7 of 15 patients (46.6%) and in group 2 there were no perforations. The occurrence rate of perforation in group 2 was significantly lower than that in group 1 (p<0.01).
CONCLUSION
The securing suture technique of autologous cartilage can be an effective method for prevention of septal perforation during septal surgery.

Keyword

Nasal septal perforation; Prevention; Autologous cartilage; Suture

MeSH Terms

Cartilage*
Humans
Methods
Mucous Membrane
Nasal Septal Perforation
Suture Techniques*
Sutures*
Tears

Figure

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  Fig. 1 After a Vicryl 5-0 suture is made intranasally through the upper edge of the site of the ipsilateral septal mucosal rupture, the suture is then passed through the mark on the graft on the outside of the nasal cavity and back through the lower edge of the septal mucosal rupture site intranasally.

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  Fig. 2 Placement of a cartilage interposition graft for repair of bilateral septal mucosal ruptures (A). Use of bayonet forceps for controlling the placement of the graft (B). Properly positioned cartilage interposition graft (C). The loose ends of the suture are then tied for securing the graft in place without tension (D).

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  Fig. 3 A securing suture technique of autologous cartilage for the prevention of septal perforation during septal surgery. S: septum, C: autologous cartilage, M: septal mucosa, SS: silastic sheet, SST: securing suture technique.

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  Fig. 4 Endoscopic view of after 2 months of surgery. Injured septal mucosa of both sides are completely healed and partially remained Vicryl 5–0 is seen (A: Right, B: Left).

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