CLINICAL QUESTION
How safe and effective is the novel “fascia taco” approach to nasal septum perforation (NSP) closure?
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July 2024BOTTOM LINE
The fascia taco technique was shown to be safe, easy to apply, and short in duration, with a high overall success rate and low morbidity in patients requiring NSP closure.
BACKGROUND: Considered challenging to treat, nasal septum perforation is a common condition affecting ~1.2% of the population. Therapeutic strategies range from conservative local treatments and septal button closures to numerous surgical approaches classified as “with osteocartilaginous support” and “without osteocartilaginous support.” Treatment success rates range from 25% to 92.5%.
STUDY DESIGN: Retrospective cohort study.
SETTING: Department of Otorhinolaryngology University Medical Center Hamburg–Eppendorf, Hamburg, Germany.
SYNOPSIS: Researchers identified 33 patients (18 females; mean age 42.7 years) who received NSP closure between 2016 and 2021 via the novel “fascia taco” NSP closure technique, in which conchal cartilage is enveloped by temporalis fascia like a taco and splints are left in place for six to eight weeks. Surgery results were evaluated in terms of safety, success rate, and degree of patient satisfaction. Perforation sizes ranged from 0.09–4.32 cm2, and the mean operative time for NSP closure only was 90.4 minutes. There was no significant association between perforation size and outcome. The overall post-operative success rate for all 33 patients was 81.8%. There was an apparent association between closure failure and smoking (failure rate 66.6% in smokers; 15.4% in nonsmokers). Patients were sent four questionnaires, including the German Sino-Nasal Outcome-Test 22 (SNOT-22) and the Nasal Obstruction Symptom Evaluation (D-NOSE), German version. Eighteen patients (11 females, mean age 45.1 years) responded. Questionnaire analysis showed a significant post-operative reduction of mean values in D-NOSE from 60.8 to 33.1 and in German-SNOT-22 from 38.6 to 21.2. Of these 1 8 respondents, 15 indicated that they would choose the same intervention again. Study limitations include its retrospective, nonrandomized, and nonblinded design.
CITATION: Bier J, Klingner A, Stadlhofer R, et al. The “fascia taco” for nasal septum perforation closure—a retrospective cohort study on success rates and patient-reported outcomes. Laryngoscope Investig Otolaryngol. 2024;9:e1248.