The bookend nasal septal splint

A New Method for Closure of Small to Medium-Size Nasoseptal Perforations

This article describes a new method of repairing nasoseptal perforations. The surgical procedure involves rotating a composite transposition flap of mucosa and cartilage anchored at the posterior margin of the perforation. The focus of the repair is to preserve vascularity to the flap and thereby enhance the survival of the cartilage and mucosa. This method appears to be most suitable for repairing small to medium-size perforations. Early success has been promising and warrants a trial by others.

Nasal ciliary beat after insertion of septo-valvular splints

OBJECTIVE

At present, endonasal paraseptal splints are devices frequently employed in rhinosurgery. We evaluated the local tolerance of a newly shaped device, the Guastella/Mantovani splint (G/M-SVS), with respect to the physiological mechanism of mucociliary clearance.

STUDY DESIGN AND SETTING

The study involved 20 patients who underwent septoplasty and/or turbinoplasty or other nasal surgical procedures. A sample of ciliated cells was obtained by nasal brushing and was examined ex vivo to determine the ciliary beat frequency (CBF) and morphology, before and 15 days after surgery.

RESULTS

Before surgery the mean CBF was 10.87 Hz +/- 0.56 Hz and when splints were removed it was 10.25 Hz +/- 1.9 Hz. Morphological evaluation of the ciliary motion after surgery demonstrated a normal, coordinated beat.

CONCLUSIONS

The G/M-SVS does not appear to interfere with the physiological mechanism of mucociliary clearance since CBF remain within a normal range.

SIGNIFICANCE

This is the first study that demonstrates an optimal tolerability and safety of the septo-valvular splints on nasal mucosa.