Retrospektive Nachuntersuchung von Patienten nach operativem Verschluss einer Nasenseptumperforation

Abstract

OBJECTIVE: The surgical closure of a nasal septal perforation (SP) is a technically difficult operation, which requires a great deal of experience of the surgeon. Amazingly, the success rate in the literature is given as about 90 %. In these studies, the retrospective follow up is generally very short. Therefore, the aim of this study was to examine the late results of surgical closures of SP. MATERIAL AND METHODS: From 2000 to 2010 a total of 348 patients received a surgical closure of a SP by using bridge flaps, open / closed approach, with / without interposition of ear cartilage. 200 patients were included. In 187 patients a complete closure has been planned. 109 (58 %) had undergone previous nose surgery. The median follow-up between surgery and last examination was 57 months (4 to 144). RESULTS: A long-term closure of the SP was achieved in 72 % (n=134). In 28 % (n=53) a recurrence occurred. In 13 patients, only a partial closure based on the size of the SP was carried out. Factors influencing success rates as well as the current literature are discussed. CONCLUSIONS: The success rates reported in the literature of more than 90 % appear to be very high. This study demonstrates that high long-term success rates are very difficult to achieve even in rhinosurgical centres. Deviations from results of other studies can be explained by very short follow-up periods and a retrospective study design in almost all cases. An appropriate informed consent of the patient before surgery is important in order to achieve realistic expectations.