Scholarlink

Objective <p>To systematically summarize the clinical characteristics of nasal septal perforation (NSP) and explore the individualized repair strategies and clinical efficacy based on nasal endoscopic techniques.</p> Methods <p>A retrospective analysis was conducted on 22 patients with nasal septal perforation treated in the Department of Otolaryngology-Head and Neck Surgery, Xijing Hospital, Air Force Medical University, from January 2020 to December 2024. The Fisher’s exact test was used to analyze the association between the choice of perforation repair surgical technique and the size of the perforation. The Wilcoxon signed-rank test was used to compare the differences in visual analog scale (VAS) scores before and after surgery.</p> Results <p>Iatrogenic perforations were found in 14 cases (63.6%), trauma-induced perforations in 2 cases (9.1%), no obvious cause in 5 cases (22.7%), and 1 case (4.5%) was caused by long-term use of intranasal corticosteroids. Among them, there were 5 small perforations (22.7%), 10 medium perforations (45.5%), and 7 large perforations (31.8%). Patients were divided into the vascular pedicled mucosal flap group and the non-vascular pedicled mucosal flap group according to their surgical methods. A significant difference was observed in the distribution of perforation sizes between the two groups (<i>p</i> &lt; 0.05). Non-vascular pedicled mucosal flaps were more frequently used for small perforations (75%), whereas vascular pedicled mucosal flaps were primarily employed for medium and large perforations. Within the vascular pedicled mucosal flap group, the choice of surgical subtype [Hadad–Bassagasteguy Flap (HBF), nasal floor, or nasoseptal–nasal floor] was also significantly related to the size of the perforation (<i>p</i> &lt; 0.01), with the nasoseptal–nasal floor mucosal flap mainly used for large perforations. During the 6-month follow-up after surgery, no complications such as bleeding, recurrence, or residual perforation occurred. Postoperative VAS scores were significantly lower than those before surgery [postoperative median: 1.5 (Q1–Q3: 1–3) vs. preoperative median: 8 (Q1–Q3: 5–10); Z = −4.123; <i>p</i> &lt; 0.001].</p> Conclusions <p>Based on the clinical characteristics of nasal septal perforations, individualized endoscopic repair strategies were adopted, with minimal surgical trauma and a low incidence of complications, along with a high surgical success rate. This study provides a new method and theoretical foundation for the precise management of nasal septal perforation.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Analysis of clinical features, diagnosis and management of nasal septal perforation

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月20日

查看全文
  • Xingchen He,
  • Yubin Lai,
  • Jiawei Chen,
  • Dingjun Zha,
  • Xiaodong Chen

摘要

Objective

To systematically summarize the clinical characteristics of nasal septal perforation (NSP) and explore the individualized repair strategies and clinical efficacy based on nasal endoscopic techniques.

Methods

A retrospective analysis was conducted on 22 patients with nasal septal perforation treated in the Department of Otolaryngology-Head and Neck Surgery, Xijing Hospital, Air Force Medical University, from January 2020 to December 2024. The Fisher’s exact test was used to analyze the association between the choice of perforation repair surgical technique and the size of the perforation. The Wilcoxon signed-rank test was used to compare the differences in visual analog scale (VAS) scores before and after surgery.

Results

Iatrogenic perforations were found in 14 cases (63.6%), trauma-induced perforations in 2 cases (9.1%), no obvious cause in 5 cases (22.7%), and 1 case (4.5%) was caused by long-term use of intranasal corticosteroids. Among them, there were 5 small perforations (22.7%), 10 medium perforations (45.5%), and 7 large perforations (31.8%). Patients were divided into the vascular pedicled mucosal flap group and the non-vascular pedicled mucosal flap group according to their surgical methods. A significant difference was observed in the distribution of perforation sizes between the two groups (p < 0.05). Non-vascular pedicled mucosal flaps were more frequently used for small perforations (75%), whereas vascular pedicled mucosal flaps were primarily employed for medium and large perforations. Within the vascular pedicled mucosal flap group, the choice of surgical subtype [Hadad–Bassagasteguy Flap (HBF), nasal floor, or nasoseptal–nasal floor] was also significantly related to the size of the perforation (p < 0.01), with the nasoseptal–nasal floor mucosal flap mainly used for large perforations. During the 6-month follow-up after surgery, no complications such as bleeding, recurrence, or residual perforation occurred. Postoperative VAS scores were significantly lower than those before surgery [postoperative median: 1.5 (Q1–Q3: 1–3) vs. preoperative median: 8 (Q1–Q3: 5–10); Z = −4.123; p < 0.001].

Conclusions

Based on the clinical characteristics of nasal septal perforations, individualized endoscopic repair strategies were adopted, with minimal surgical trauma and a low incidence of complications, along with a high surgical success rate. This study provides a new method and theoretical foundation for the precise management of nasal septal perforation.