ACTUALITY

In the structure of complications of rhinosurgery, the incidence of postoperative nasal septum perforation (PNSP) is 1—8%. Recurrence of perforation of the nasal septum (NS) is detected in 7—37% of cases. The relevance of the search and development of an effective method of surgical treatment of PNSP is beyond doubt.

AIM OF STUDY

Evaluate the effectiveness of PNSP surgical treatment techniques.

PATIENTS AND METHODS

Fifty-two patients with PNSP with sizes ranging from 8×9 to 28´17 mm were examined. In the main group (26 patients), the closure of the PNSP was performed according to the original method (patent RU 2705268), in the control group (26 patients) — according to the method of P. Castelnuovo. In the postoperative period, the state of the mucous membrane (MM) and supporting tissues of the NS was assessed by VAS, the severity of the inflammatory process was assessed by cytological examination, the transport function of the ciliated epithelium and the function of nasal breathing were assessed by the NOSE questionnaires..

RESULTS

According to the cytological study, in the main group, compared with the control group, the infiltration of leukocytes on the 15th day after the operation was less by 46%, the reactive changes in MM were less pronounced by 24%, on the 30th day — by 43%, the NS tissue elasticity index on the 30th day was 48% higher, on the 90th — by 45.16% (p≤0.01). The values of the saccharin test in the main group were higher by 21% on the 15th day and by 18% on the 30th day (p≤0.01), the NOSE score on the 15th day was better by 21.6%, by 30th day — by 58.9% than in the control group (p≤0.01). In the main group, recurrence of PNSP was noted in 4% of cases, in the control group — in 27%.

CONCLUSIONS

The use of the developed method of closing the PNSP with an autograft allows the formation of a strong scar membrane in the area of the closed PNSP and reduces the number of relapses. In this case, the course of the wound process is accompanied by less pronounced signs of inflammation, which contributes to the rapid restoration of the transport function of MM and the respiratory function of the nose.