Usefulness of autologous cartilage and fibrin glue for the prevention of septal perforation during septal surgery: A preliminary report

OBJECTIVES: Septal surgery is one of the most common causes of nasal septal perforation. In cases in which a septal mucosal defect at the corresponding area has occurred, autologous cartilage is usually inserted between the injured mucosal flaps. In addition, we applied fibrin glue to the margins of injured mucosal surface to fix the inserted cartilage and to promote mucosal regeneration. The aim of this study was to evaluate the efficacy of this method in the prevention of nasal septal perforation. STUDY DESIGN: Retrospective analysis of medical records. METHODS: A total of 463 septal surgeries were performed between March 2003 and August 2005. Septal mucosal defect at the corresponding area occurred in 34 patients. In group 1 (23 patients), septal or auricular cartilage was inserted between the injured mucosal flaps. In group 2 (11 patients), septal or auricular cartilage was inserted, and fibrin glue was applied on the mucosal margins of cartilage insertion site. We compared the perforation rate between the two groups. RESULTS: In group 1, nasal septal perforation occurred 8 of 23 (34.8%) patients, and in group 2, 1 of 11 (9.1%) patients experienced perforation. Although the occurrence rate of perforation was significantly lower in group 2, statistical significance between the two groups could not be established because of the small number of patients who experienced septal perforation. CONCLUSION: The application of fibrin glue at the bilaterally injured mucosal surface after cartilage insertion is thought to be very useful as a preventive measure of nasal septal perforation. We report these results as preliminary data for further study to determine the usefulness of fibrin glue in the prevention of nasal septal perforation.