Pedicled lateral nasal wall flap for the reconstruction of the nasal septum perforation. A radio-anatomical study

Isam Alobid, Eric Mason, C. Arturo Solares, Daniel Prevedello, Joaquim Enseñat, Matteo De Notaris, Alberto Prats-Galino, Manuel Bernal-Sprekelsen, Ricardo Carrau

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Introduction: The aim of this radio-anatomical study is to ensure that the potential donor area of the pedicled lateral nasal wall flap (PLNW) is adequate to reconstruct nasal perforation. Material and methods: Analysis was conducted on 40 de-identified CT angiographies. The area and length of the PLNW, the septum, and the nasal floor were measured. In a cadaver study, 20 hemi-cranial sagittal sections were also analyzed. The anteriorposterior length of the PLNW flap and the distance between the sphenopalatine foramen and piriform aperture were measured. A clinical study with endoscopic closure of a large perforation was conducted in three patients. Results: The CT angiographies demonstrated an average PLNW area of 10.80 ± 1.13 cm2 and a nasal floor area of 3.78 ± 0.58 cm2. The septal area (22.54 ± 21.32 cm2) was significantly larger than the total PLNW flap area (14.59 ± 1.21 cm2). The average length of the flap was 5.58 ± 0.39 cm, while the septum was 6.66 ± 0.42 cm; therefore the PLNW flap is insufficient to reconstruct the entire septum. The cadaver study showed that the length of the PLNW flap was 5.28 ± 0.40 cm. These results demonstrate that measurements obtained from CT scans are reliable data and similar to those found in the radiological study. Complete closure was achieved in all three patients. Conclusion: The PLNW flap does not render enough tissue to reconstruct a total septal perforation; however, up to 84% of the septum could be repaired with a PLNW. The potential donor area obtained by CT scan and clinical practice support the approachability of PLNW to repair large septal perforation.

Original languageEnglish (US)
Pages (from-to)235-241
Number of pages7
JournalRhinology
Volume53
Issue number3
DOIs
StatePublished - Jan 1 2015

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Nasal Septal Perforation
Radio
Nose
Cadaver
Tissue Donors
Septum of Brain
Nasal Septum

Keywords

  • Pedicle lateral nasal wall flap
  • Pedicled nasoseptal flap
  • Septal closure
  • Septal perforation
  • Septal repair

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Alobid, I., Mason, E., Solares, C. A., Prevedello, D., Enseñat, J., De Notaris, M., ... Carrau, R. (2015). Pedicled lateral nasal wall flap for the reconstruction of the nasal septum perforation. A radio-anatomical study. Rhinology, 53(3), 235-241. https://doi.org/10.4193/Rhino14.042

Pedicled lateral nasal wall flap for the reconstruction of the nasal septum perforation. A radio-anatomical study. / Alobid, Isam; Mason, Eric; Solares, C. Arturo; Prevedello, Daniel; Enseñat, Joaquim; De Notaris, Matteo; Prats-Galino, Alberto; Bernal-Sprekelsen, Manuel; Carrau, Ricardo.

In: Rhinology, Vol. 53, No. 3, 01.01.2015, p. 235-241.

Research output: Contribution to journalArticle

Alobid, I, Mason, E, Solares, CA, Prevedello, D, Enseñat, J, De Notaris, M, Prats-Galino, A, Bernal-Sprekelsen, M & Carrau, R 2015, 'Pedicled lateral nasal wall flap for the reconstruction of the nasal septum perforation. A radio-anatomical study', Rhinology, vol. 53, no. 3, pp. 235-241. https://doi.org/10.4193/Rhino14.042
Alobid I, Mason E, Solares CA, Prevedello D, Enseñat J, De Notaris M et al. Pedicled lateral nasal wall flap for the reconstruction of the nasal septum perforation. A radio-anatomical study. Rhinology. 2015 Jan 1;53(3):235-241. https://doi.org/10.4193/Rhino14.042
Alobid, Isam ; Mason, Eric ; Solares, C. Arturo ; Prevedello, Daniel ; Enseñat, Joaquim ; De Notaris, Matteo ; Prats-Galino, Alberto ; Bernal-Sprekelsen, Manuel ; Carrau, Ricardo. / Pedicled lateral nasal wall flap for the reconstruction of the nasal septum perforation. A radio-anatomical study. In: Rhinology. 2015 ; Vol. 53, No. 3. pp. 235-241.
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AU - Solares, C. Arturo

AU - Prevedello, Daniel

AU - Enseñat, Joaquim

AU - De Notaris, Matteo

AU - Prats-Galino, Alberto

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AB - Introduction: The aim of this radio-anatomical study is to ensure that the potential donor area of the pedicled lateral nasal wall flap (PLNW) is adequate to reconstruct nasal perforation. Material and methods: Analysis was conducted on 40 de-identified CT angiographies. The area and length of the PLNW, the septum, and the nasal floor were measured. In a cadaver study, 20 hemi-cranial sagittal sections were also analyzed. The anteriorposterior length of the PLNW flap and the distance between the sphenopalatine foramen and piriform aperture were measured. A clinical study with endoscopic closure of a large perforation was conducted in three patients. Results: The CT angiographies demonstrated an average PLNW area of 10.80 ± 1.13 cm2 and a nasal floor area of 3.78 ± 0.58 cm2. The septal area (22.54 ± 21.32 cm2) was significantly larger than the total PLNW flap area (14.59 ± 1.21 cm2). The average length of the flap was 5.58 ± 0.39 cm, while the septum was 6.66 ± 0.42 cm; therefore the PLNW flap is insufficient to reconstruct the entire septum. The cadaver study showed that the length of the PLNW flap was 5.28 ± 0.40 cm. These results demonstrate that measurements obtained from CT scans are reliable data and similar to those found in the radiological study. Complete closure was achieved in all three patients. Conclusion: The PLNW flap does not render enough tissue to reconstruct a total septal perforation; however, up to 84% of the septum could be repaired with a PLNW. The potential donor area obtained by CT scan and clinical practice support the approachability of PLNW to repair large septal perforation.

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