Endoscopic repair of nasal septal perforation with acellular dermal matrix and pedicled mucoperichondrial flap / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To introduce the method and evaluate the efficacy of endoscopic repair of nasal septal perforation with acellular dermal matrix and pedicled mucoperichondrial flap.</p><p><b>METHODS</b>Twelve patients with perforation of nasal septum were encountered since February 2006 to October 2010. The most common symptoms and sings were nasal obstruction and crusting at the margin of the perforation. Eight of 12 patients were iatrogenic following surgery. The perforation typically located at anterior medial part of the nasal septum, with their sizes ranged approximately 1.0-2.3 cm in diameter. The incision was made at the anterior edge of the perforation from the left nasal cavity and continued to the nasal floor horizontally. It ended at the lateral nasal cavity. Then, another incision was made parallel to the first one, which was 1.5 cm from the posterior of the perforation. The two incisions was connected. The mucoperichondrium was stripped along with the incisions and the pedicle of mucoperichondrial flap kept on the nasal septum. Then, the flap was turned up to cover the perforation and fixed with apposition suture. Put the acellular dermal matrix graft on the perforation from the right nasal cavity and fixed it with apposition suture.</p><p><b>RESULTS</b>The healing of the acellular dermal matrix and mucoperichondrium was good in the first week postoperatively and there was no rejective reaction and contracture. The epithelization of the nasal septal perforation finished 4 weeks after surgery. Follow-up ranged from 3 months to 4 years. Eleven patients had successful outcomes with complete closure of their perforations. One patient failed the operation. All of them had no complications.</p><p><b>CONCLUSIONS</b>Using acellular dermal matrix graft and mucoperichondrial flap to repair the septal perforation is a simple method and the success rate is high. Therefore, it is an effective way to repair the perforation of nasal septum.</p>

Diagnosis and endoscopic treatment of sphenoid mycetoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the presenting symptoms and signs, endoscopic findings, imaging changes and the clinical outcomes of endoscopic surgery in 23 patients with sphenoid mycetoma.</p><p><b>METHODS</b>The clinical data and the follow-up results of endoscopic surgery in 23 patients with sphenoid mycetoma, between April 2001 and January 2006, were retrospectively analysed.</p><p><b>RESULTS</b>The study population included 15 women and 8 men with a median age of 52.7 years. Presenting symptoms included headache (13 cases, 57%) and bloody discharge (9 cases, 48%). The computed tomography scans showed high density shadow in all 23 cases, with 17 cases (74%) had plaque or cord shaped calcification. All patients were treated by endoscopic transnasal approach. No surgical complications were found. Follow-up ranged 3-18 months, all symptoms disappeared, except strabismus in one case after 7 months of operation. The mucosa in surgical cavity is good.</p><p><b>CONCLUSIONS</b>The most common clinical symptoms of sphenoid mycetoma are headache and bloody discharge. Computed tomography scan has great value for the diagnosis of sphenoid mycetoma. The minimal invasion and the good outcome are the main advantages of the endoscopic surgery.</p>