Bilateral Versus Unilateral Repair of Nasal Septal Perforation: A Two-Center Retrospective Study.

IF 2.2 3区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Laryngoscope Pub Date : 2024-11-20 DOI:10.1002/lary.31922

Yury Rusetsky, Vladimir Averbukh, Zhanna Mokoyan, Nikolay Daykhes, Anna Elumeeva, Darya Volkova

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引用次数: 0

Abstract

Background: There are two main approaches for nasal septal perforation (NSP) surgery-bilateral and unilateral repair. There are advantages and disadvantages to each of these techniques. At the same time, there is a lack of comparative studies on the effectiveness of these approaches. The study aims to compare the effectiveness of unilateral and bilateral closure of NSP.

Methods: A total of 99 patients with symptomatic NSP underwent surgery between 2021 and 2022 and were followed up at two large tertiary centers. The "unilateral closure" group (Group 1, N = 47) utilized an anterior ethmoidal artery (AEA) flap to close the perforations. Group 2 (N = 52) consisted of patients, who underwent bilateral closure of NSP.

Results: Complete closure of the NSP was achieved in 39 of 47 (83%) patients in Group 1 and in 48 of 52 (92.3%) patients in Group 2. There was a trend toward a higher incidence of incomplete defect closure among Group 1 patients when analyzing the subgroups of large (>2 cm) NSP (RR = 2.75 [95% CI: 0.96; 7.87], p = 0.072). There was a statistically significant decrease in SNOT-25 score after surgery in each of the study groups (p < 0.001) with no significant differences between groups (p = 0.51).

Conclusions: The relative advantages of the thin flap are outweighed by the obtained data of higher efficacy of the bilateral technique in large NSP cases. Therefore, in cases of surgical repair of small and medium-sized NSP, the closure rates after single-layer and double-layer closure are comparable.

Level of evidence: III Laryngoscope, 2024.

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鼻中隔穿孔的双侧与单侧修复术：双中心回顾性研究

背景：鼻中隔穿孔（NSP）手术主要有两种方法--双侧修复和单侧修复。这两种方法各有利弊。同时，也缺乏对这些方法有效性的比较研究。本研究旨在比较单侧和双侧关闭 NSP 的有效性：方法：在 2021 年至 2022 年期间，共有 99 名有症状的 NSP 患者接受了手术，并在两家大型三级医院接受了随访。单侧闭合 "组（第1组，N = 47）采用乙状前动脉（AEA）皮瓣闭合穿孔。第 2 组（N = 52）的患者接受了双侧 NSP 闭合术：第一组 47 例患者中有 39 例（83%）实现了 NSP 完全闭合，第二组 52 例患者中有 48 例（92.3%）实现了 NSP 完全闭合。在分析大型（>2 厘米）NSP 亚组时，第一组患者的缺损未完全闭合发生率呈上升趋势（RR = 2.75 [95% CI: 0.96; 7.87]，P = 0.072）。各研究组术后 SNOT-25 评分均有统计学意义上的显著下降（P 结论：NSP 术后 SNOT-25 评分均有统计学意义上的显著下降：在大面积 NSP 病例中，双侧技术的疗效更高，这与薄皮瓣的相对优势相比有过之而无不及。因此，在中小型 NSP 手术修复病例中，单层和双层闭合后的闭合率相当：III 《喉镜》，2024 年。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Laryngoscope 医学-耳鼻喉科学

CiteScore

6.50

自引率

7.70%

发文量

500

审稿时长

2-4 weeks

期刊介绍： The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope. • Broncho-esophagology • Communicative disorders • Head and neck surgery • Plastic and reconstructive facial surgery • Oncology • Speech and hearing defects