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

12 Scopus citations

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 - Sep 24 2015

Keywords

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

ASJC Scopus subject areas

  • Otorhinolaryngology

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    Alobid, I., Mason, E., Solares, C. A., 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, 53(3), 235-241. https://doi.org/10.4193/Rhino14.042