[Optimization of the plastic closure of perforations in the nasal septum with the use of vector analysis of CT-anatomy of the nasal cavity].

The objective of the present study was to develop a planar template reflecting the spatial location of mucoperichondrium/mucoperiosteum in the nasal cavity that can be used to shape pedicled flaps for the plastic closure of perforations in the nasal septum. The vector analysis of computed tomograms of the nasal cavity obtained from 73 patients was employed to determine the size of the mucoperichondrium/mucoperiosteum of the septum, floor, and lateral wall of the nasal cavity. The resulting picture (template) has the form of an irregular polygon. Extrapolation of real perforation to such template makes it possible to more rationally plan surgery for the plastic closure of perforations in the nasal septum.

[The surgical strategy for the treatment of intraoperative ruptures of nasal septal mucosa (part II)].

The objective of the present study was to develop the surgical strategy for the treatment of intraoperative mucosal ruptures on the nasal septum. This paper highlights the problems of etiology and pathogenesis of postoperative perforations in the nasal septum. The intraoperative mucoperichondrial ruptures are considered to be the principal risk factors of septal perforations. A total of 188 patients suffering unilateral linear mucosal ruptures in the nasal septum following septoplasty were available for observation during the period spanning from 2009 to 2011. It was shown that postoperative defects in septal mucosa eventually lead to the long-term persistent collapse of mucociliary activity. A surgical strategy for the management of interoperative mucosal ruptures of the nasal cavity has been developed taking into account the character and the length of the ruptures. An original method is proposed for the fixation of mucoperichondrial flaps used for the plastic closure of intraoperative defects in septal mucosa. The data obtained provided a basis for the development of recommendations to be used by otorhinolaryngologists for the purpose of both septoplasty and plastic closure of perforations in the nasal septum.

[The surgical strategy for the treatment of intraoperative ruptures of nasal septal mucosa (part 1)].

The objective of the present study was to develop the surgical strategy for the management of intraoperative ruptures of nasal septal mucosa. The paper highlights etiology and pathogenesis of postoperative perforations of the nasal septum. The intraoperative ruptures of nasal septal mucosa were shown to be the major factors responsible for the enhanced risk of nasal septum perforation. A total of 188 patients presenting with unilateral linear intraoperative ruptures of nasal septal mucosa that occurred in the course of the septoplastic intervention were available for the observation during a period from 2009 to 2011. The study has demonstrated that the defects in intranasal mucosa developing in the late postoperative period cause a sustained collapse of the mucociliary activity. The up-to-date techniques were used to develop the surgical strategy for the treatment of intraoperative ruptures of nasal septal mucosa depending on their length and character. An original method is proposed for fixing mucoperichondrial flaps for the plastic closure of the intraoperative defects of nasal septal mucosa. The results of the study provided a basis for the development of practical recommendations to be used by otorhinolaryngologists for the purposes of both septoplasty and plastic closure of perforations in the nasal septum.

[Surgical intervention on the middle and upper segments of the bone portion of the nasal septum].

The vector analysis of computed tomograms of the nose and paranasal sinuses of 102 patients was carried out to study the spatial relationship between lamina cribrosa and the area of surgical intervention at the perpendicular plate of the ethmoid bone. Simultaneously, specific syntopic features of the middle and upper zones of the bony portion of the nasal septum were determined. The data obtained were used to develop the method for the sparing surgical intervention on the middle and upper levels of the bony portion of the nasal septum.