For citation: Rusetsky Yu.Yu., Spiranskaya O.A., Mokoyan Zh.T., Gromov K.S., Spiranskaya A.P., Elumeeva A.N. Long-term results of endoscopic repair of nasal septal perforations in children. Head and neck. Russian Journal. 2021;9(4):40–50 (In Russian).
The authors are responsible for the originality of the data presented and the possibility of publishing illustrative material – tables, figures, photographs of patients.
Introduction. Nasal septal perforation closure remains one of the most challenging issues in rhinosurgery, especially in children. The reliability of surgical treatment, the optimal age and the best surgical technique have not yet been uniquely defined. Moreover, the data on surgical perforation closure outcomes in children are still contradictory. Based on the few available publications, it is obvious that the effectiveness of this type of surgery in the pediatric population is much lower than in adults. Widespread application of endoscopic equipment led to considerable changes in surgical techniques of nasal septal perforation closure in adults. In pediatric otorhinolaryngology, endoscopic approach also appears promising, since a pediatric patient requires less invasive techniques with good visualization of the surgical field. However, the introduction of endoscope-assisted techniques into this field of rhinosurgery is dealyed, due to insufficient data on long-term outcomes in children.
Purpose of the study. This study aimed to evaluate the long-term results of different endoscopic techniques for closure of nasal septal perforations in children.
Material and methods. Twenty four children with nasal septal perforations were operated at the ENT department of National Medical Research Center of Children’s Health (Moscow, Russia) using different techniques from February 2015 to May 2018. Originally developed techniques were applied in 16 patients. All patients were followed up to assess the effectiveness of surgical treatment and relief of clinical symptoms. The interim evaluation of surgical outcomes between 12 and 36 months of the follow-up has revealed the total nasal septal perforation repair achievement in 19 of the 24 patients (79%). Currently, 2–5 years after surgery, 17 of the 24 surgical procedures resulted in a complete closure, with a 70.8% success rate.
Conclusion. Endoscopic-assisted approach, use of vascularized mucoperichondrial flaps, and bilateral closure have shown their high efficiency in the surgical repair of the nasal septal perforation in children, and feasibility for further practical use. The occurrence of residual perforations during the long-term follow-up period identifies the need for prolonged postoperative care in these patients.
Key words: nasal septal perforation, surgical repair of nasal septal perforation, comparison of different techniques for surgical closure of nasal septal perforation
Conflicts of interest. The authors have no conflicts of interest to declare. Funding. There was no funding for this study.