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KMID : 0361020220650010024
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Korean Journal of Otolaryngology - Head and Neck Surgery
2022 Volume.65 No. 1 p.24 ~ p.29
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Interposition Technique for Septal Perforation Using a Composite Graft Made Up of Allograft Dermal Matrix and Autologous Cartilage
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Kim Dong-Young
Kim Joo-Yeon
Cha Jun-Sang
Kwon Jae-Hwan
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Abstract
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Background and Objectives : Interposition using acellular allograft between perforated septalflaps is a popular procedure among surgeons because of its usefulness. However, allograftdermal matrix itself tends to become infected sometimes, and can easily undergo necrosis or bedisplaced from the implanted site. Here, the authors would like to introduce a newly devisedinterposition graft made up of allograft and cartilage, which is easy to manipulate and can befixed in the desired position.
Subjects and Method : We performed a retrospective chart review from January 2018 toAugust 2020. A total of 12 patients with septal perforation who received surgical treatmentwere included in this study. Acellular human dermal allograft (MegaDerm®; L&C Bio) wasused as an interposition allograft piled up by autologous cartilage, and it was positioned betweenthe mucoperichondrial flaps via the endonasal approach.
Results : The most common etiology was previous septal surgery (n=8); in one case, the etiologywas repeated electrocauterization due to frequent epistaxis; the etiology was not verifiedfor three cases. All 12 cases achieved the result of complete septal perforation closure. All patientson follow-up inquiry reported marked improvements in the visual analogue scale score(mean value, 4.1 to 1) and Nasal Obstruction Symptom Evaluation scale (mean value, 7.3 to 1.8).
Conclusion : Composite graft made up of cartilage and allograft dermal matrix achieved successfulresults without having to fix the graft. It can be an alternative technique to treat septalperforation for inexperienced surgeons and with a limited operation field.
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KEYWORD
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Allograft, Nasal septal perforation, Septoplasty
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