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Unformatted text preview: ination Recurrence after flap takedown Young. “Closure of the nostril in atrophic rhinitis.” Journal of Laryngology and Otology, 81: 515­524. Nasal Closure Nasal Closure Modified Young’s Advantages Elevation of extended perichondrial flap through contralateral hemitransfixion incision. Short skin flap elevated from the intercartilaginous line on the ipsilateral side. Suture lateral and medial flaps with vicryl. Staged second side with first side takedown in 6 mon. Technically easier than Young procedure No suture line breakdown No vestibular stenosis on takedown Disadvantages Not possible with large septal defects Does not allow for cleaning Does not allow for periodic examination Recurrence after flap takedown El Kholy, Habib, Abdel­Monem, Safia. “Septal mucoperichondrial flap for closure of nostril in atrophic rhinitis.” Rhinology, 36, 202­203, 1998. Modified Young Modified Young Volume reduction Volume reduction Plastipore implantation Advantages Porus material allows tissue ingrowth. Implants shaped then fenestrated for ingrowth. Implants placed submucosally along the septum and nasal floor. Easier than other surgical options (Young’s) Plastipore has low extrusion/complication rate May be done under local anesthesia Disadvantages Possibility of extrusion (occurred in 1/8 pts) Requires septal mucosa (not discussed) Goldenberg, Danino, Netzer, Joachims. Oto HNS, Vol. 122 (6). pp. 794-97. Plastipore Plastipore Volume Reduction (cont) Volume Reduction (cont) Triosite and Fibrin Advantages Triosite (60% hydroxyapetite, 40% calcium triphosphate) mixed with Fibrin 1:1. Deglove the labial vestibule Elevate periosteum of the floor posteriorly to the end of the hard palate, extend medially onto the septum. Insert Triosite & Fibrin mixture (~3.3g per side) Good to excellent result (7/9 patients) Material can be molded easily Disadvantages Leakage of material (4/9 patients) Infection of material (3/9 patients) Potential damage to lacrimal system Bertrand, Doyen, Eloy. Laryngoscope 106: May 1996. p 6...
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