Open AccessPedicled lateral nasal wall flap for the reconstruction of the nasal septum perforation. A radio-anatomical study
Author(s) -
Isam Alobid,
Eric F. Mason,
C. Arturo Solares,
Daniel M. Prevedello,
Joaquim Enseñat,
Matteo de Notaris,
Alberto Prats-Galino,
Manuel BernalSprekelsen,
Ricardo L. Carrau
Publication year - 2015
Publication title -
rhinology (amsterdam. online)/rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.275
H-Index - 57
eISSN - 1996-8604
pISSN - 0300-0729
DOI - 10.4193/rhino14.042
Subject(s) - medicine , nasal septum , perforation , cadaver , anatomy , sagittal plane , foramen , lateral wall , surgery , nuclear medicine , nose , mechanical engineering , materials science , metallurgy , engineering , punching
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 anterior-posterior 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.