Closure of nasal septal perforations by individually configured epthesis

Not in all patients surgical repair of a septal perforation is possible. The occlusion with a conventional septum button (CSB) is an option. In cases of defects in the area of the nasal valve, deviated nasal septum, differences in septal thickness and large perforations CSB is unsuitable due to thickness and straight shape.

From 03/2015 to 09/2017, a total of 30 patients (median age 60.4 years, min. 32, max. 87 years, women n = 8) were treated with a individually configured septal epithesis (ISE). This included an endonasal imprint with silicone (Co-Form Soft M-517, Technovent Ltd., UK), a plaster model and the manufacture of the epithesis with transparent silicone (Odontosil, Dreve Dentamid GmbH, Germany). The epitheses were inserted under local anesthesia and checked regularly for alterations in fitting and material quality.

The inner dimensions of ISE ranged from a minimum of 6 × 8 mm to a maximum of 23 × 38 mm with an additional external groove of 2 – 3 mm by which the epithesis was completely surrounded to ensure a safe fixation. The maximum thickness of the material was less than 2 mm and as kept very thin in the area of the perforation. The follow-up was performed every six months. In two cases, the ISE had to be renewed due to a change in the shape of the perforation. In one case there was a fungal colonization of the ISE. The building of incrustations was not observed and a removal has not been necessary in any patient so far.

The individually configured epithesis is a substantial improvement compared to conventional septal buttons because the epithesis can be adjusted to the individual anatomy of the patient. Due to its secure fixation the risk of bleeding and incrustation is considerably reduced. The subjective satisfaction is very high among patients.

Publikationsverlauf

Publikationsdatum:
18. April 2018 (online)