gms | German Medical Science

Introduction: With the surgical closing of a nasal septum defect usually a body-own transplantat is being used. The goal of our own exam and investigation was to examine a biological implant that is permitted for any soft tissue exchange, for its longterm stability.

Method: The steps of the surgery were only executed endonasally via a transcolumellar approach on the right according to Stange and Schultz-Coulon (2009). To stabalize Permacol™ was used in four cases on one single-side and in one case on both sides with a thickness of 0.5 mm. The size of the implant was according to the size of the defect and was suited individually. It reaches from the nasal floor under the nasal back. The bipedicled flaps were fixated with single-button-sutures horizontally and the implant by using transseptal sutures. The clinical and video-endoscopical results that have been documented in regular timely check-ups are shown in a post-observation ckeck-up time frame of 12–30 months.

Results: Looking at the four patients with a single-sided implant for the long-term a stable closing of the nasal septum perforation could successfully be observed. The patient satisfaction was very high. Looking at the double-sided implant, which was used because of the size of the defect was greater than 10 mm, only a safe closing was to be observed for 12 months. After 12 months a rezidiv perforation with a chronic inflammation of the mucosa and a lacking vascularisation account of a nasal septal operation many years before was found. There are no morphologically tangible reactions to Permacol™.

Conclusion: Using Permacol™ a stable closing is able to be accomplished with our patient base in single side application. It is available quickly during surgery and it is also available in different sizes a thicknesses. No additional body-own tissue is required. A present chronic inflammation of the nasal mucosa should be treated pre-operatively.