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J Cosmet Med 2023; 7(2): 77-80

Published online December 31, 2023

https://doi.org/10.25056/JCM.2023.7.2.77

Surgical repair of nasal septal perforation using temporalis fascia and homologous rib cartilage grafts: a case report

Jun Kim, MD, PhD1 , Sue Jean Mun, MD, PhD2 , Tae Ui Hong, MD3

1Baroko Clinic, Seoul, Rep. of Korea
2Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Yangsan Hospital, Yangsan, Rep. of Korea
3Department of Otorhinolaryngology-Head and Neck Surgery, Inje University Busan Paik Hospital, Busan, Rep. of Korea

Correspondence to :
Tae Ui Hong
E-mail: tae9858@naver.com

Received: November 14, 2023; Revised: December 1, 2023; Accepted: December 5, 2023

© Korean Society of Korean Cosmetic Surgery & Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Nasal septal perforation, often encountered as a complication of rhinoplasty, presents a significant clinical challenge, particularly following procedures focused on nose lengthening or augmenting, such as septal extension surgeries. Herein, we present a case of septal perforation, which was successfully treated through a temporalis fascia graft combined with costal cartilage graft from a donor. We explored the etiology of nasal septal perforation and delved into various treatment options through this investigation involving a female patient who experienced persistent crusting and nasal obstruction following rhinoplasty. The surgical approach adopted for the case and the outcomes, and the nuances in managing septal perforation complexity are presented.

Keywords: costal cartilage, fascia, nasal septal perforation, rhinoplasty, transplants

Fig. 1.Preoperative findings. The nasal cavity shows a circular septal perforation approximately 1 cm in diameter in the mid-septal area. (A) Left nasal cavity. (B) Sagittal view of cone-beam computed tomography.
  1. Yang SC, Lee BK, Lee JH, Kim CD. Repair of the septal perforation by temporalis fascia autografting and mucosal advancement flap. Korean J Otolaryngol Head Neck Surg 1996;39:1492-6.
  2. Lee CU, Kang SH, Lee HS, Ahn KS. Repair of large septal perforation by external rhinoplasty approach. Korean J Otolaryngol Head Neck Surg 1991;34:1232-6.
  3. Hong SK, Min YG. Repair of nasal septal perforation by intranasal approach using a free composite graft of the auricular cartilage and the temporalis muscle fascia. Korean J Otolaryngol Head Neck Surg 2002;45:969-74.
  4. Re M, Paolucci L, Romeo R, Mallardi V. Surgical treatment of nasal septal perforations. Our experience. Acta Otorhinolaryngol Ital 2006;26:102-9.
  5. Mocella S, Muia F, Giacomini PG, Bertossi D, Residori E, Sgroi S. Innovative technique for large septal perforation repair and radiological evaluation. Acta Otorhinolaryngol Ital 2013;33:202-14.
  6. Cassano M. Endoscopic repair of nasal septal perforation. Acta Otorhinolaryngol Ital 2017;37:486-92.
    Pubmed KoreaMed CrossRef
  7. Delaney SW, Kridel RWH. Contemporary trends in the surgical management of nasal septal perforations: a community survey. Facial Plast Surg 2019;35:78-84.
    Pubmed CrossRef
  8. Cavada MN, Orgain CA, Alvarado R, Sacks R, Harvey RJ. Septal perforation repair utilizing an anterior ethmoidal artery flap and collagen matrix. Am J Rhinol Allergy 2019;33:256-62.
    Pubmed CrossRef
  9. Virkkula P, Mäkitie AA, Vento SI. Surgical outcome and complications of nasal septal perforation repair with temporal fascia and periosteal grafts. Clin Med Insights Ear Nose Throat 2015;8:7-11.
    Pubmed KoreaMed CrossRef
  10. Kadakia N, Nguyen C, Motakef S, Hill M, Gupta S. Is irradiated homologous costal cartilage reliable? A meta-analysis of complication rates in rhinoplasty. Plast Surg (Oakv) 2022;30:212-21.
    Pubmed KoreaMed CrossRef

Article

Case Report

J Cosmet Med 2023; 7(2): 77-80

Published online December 31, 2023 https://doi.org/10.25056/JCM.2023.7.2.77

Copyright © Korean Society of Korean Cosmetic Surgery & Medicine.

Surgical repair of nasal septal perforation using temporalis fascia and homologous rib cartilage grafts: a case report

Jun Kim, MD, PhD1 , Sue Jean Mun, MD, PhD2 , Tae Ui Hong, MD3

1Baroko Clinic, Seoul, Rep. of Korea
2Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Yangsan Hospital, Yangsan, Rep. of Korea
3Department of Otorhinolaryngology-Head and Neck Surgery, Inje University Busan Paik Hospital, Busan, Rep. of Korea

Correspondence to:Tae Ui Hong
E-mail: tae9858@naver.com

Received: November 14, 2023; Revised: December 1, 2023; Accepted: December 5, 2023

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Nasal septal perforation, often encountered as a complication of rhinoplasty, presents a significant clinical challenge, particularly following procedures focused on nose lengthening or augmenting, such as septal extension surgeries. Herein, we present a case of septal perforation, which was successfully treated through a temporalis fascia graft combined with costal cartilage graft from a donor. We explored the etiology of nasal septal perforation and delved into various treatment options through this investigation involving a female patient who experienced persistent crusting and nasal obstruction following rhinoplasty. The surgical approach adopted for the case and the outcomes, and the nuances in managing septal perforation complexity are presented.

Keywords: costal cartilage, fascia, nasal septal perforation, rhinoplasty, transplants

Fig 1.

Figure 1.Preoperative findings. The nasal cavity shows a circular septal perforation approximately 1 cm in diameter in the mid-septal area. (A) Left nasal cavity. (B) Sagittal view of cone-beam computed tomography.
Journal of Cosmetic Medicine 2023; 7: 77-80https://doi.org/10.25056/JCM.2023.7.2.77

References

  1. Yang SC, Lee BK, Lee JH, Kim CD. Repair of the septal perforation by temporalis fascia autografting and mucosal advancement flap. Korean J Otolaryngol Head Neck Surg 1996;39:1492-6.
  2. Lee CU, Kang SH, Lee HS, Ahn KS. Repair of large septal perforation by external rhinoplasty approach. Korean J Otolaryngol Head Neck Surg 1991;34:1232-6.
  3. Hong SK, Min YG. Repair of nasal septal perforation by intranasal approach using a free composite graft of the auricular cartilage and the temporalis muscle fascia. Korean J Otolaryngol Head Neck Surg 2002;45:969-74.
  4. Re M, Paolucci L, Romeo R, Mallardi V. Surgical treatment of nasal septal perforations. Our experience. Acta Otorhinolaryngol Ital 2006;26:102-9.
  5. Mocella S, Muia F, Giacomini PG, Bertossi D, Residori E, Sgroi S. Innovative technique for large septal perforation repair and radiological evaluation. Acta Otorhinolaryngol Ital 2013;33:202-14.
  6. Cassano M. Endoscopic repair of nasal septal perforation. Acta Otorhinolaryngol Ital 2017;37:486-92.
    Pubmed KoreaMed CrossRef
  7. Delaney SW, Kridel RWH. Contemporary trends in the surgical management of nasal septal perforations: a community survey. Facial Plast Surg 2019;35:78-84.
    Pubmed CrossRef
  8. Cavada MN, Orgain CA, Alvarado R, Sacks R, Harvey RJ. Septal perforation repair utilizing an anterior ethmoidal artery flap and collagen matrix. Am J Rhinol Allergy 2019;33:256-62.
    Pubmed CrossRef
  9. Virkkula P, Mäkitie AA, Vento SI. Surgical outcome and complications of nasal septal perforation repair with temporal fascia and periosteal grafts. Clin Med Insights Ear Nose Throat 2015;8:7-11.
    Pubmed KoreaMed CrossRef
  10. Kadakia N, Nguyen C, Motakef S, Hill M, Gupta S. Is irradiated homologous costal cartilage reliable? A meta-analysis of complication rates in rhinoplasty. Plast Surg (Oakv) 2022;30:212-21.
    Pubmed KoreaMed CrossRef

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