Ivan V Krainik
National Medical-Surgical Centre by N I Pirogov, Russia
Posters & Accepted Abstracts: Anaplastology
Respiratory malfunction as a result of septum deformation is a widespread otolaryngological pathology. In recent years many different methods of respiratory function recovery were developed but post operational aftereffects (septum penetration mucous tunic atrophy, sub-mucous hematomas) still remains significant problem. We developed a new method of full nasal septum cartilage recovery using auto cartilage fragment and platelet rich plasma (PRP) of human blood. Extracted deformed fragments of quadrangular cartilage are pulverized and placed into auto plasma. Solution of 10% CaCl2 (4 drops per 1 ml) is used as a catalyst for plasma polymerisation. Small pieces of cartilage are wrapped into thrombocytic fibrous clots resulting in Platelet-Cartilage Autograft (PPCA) with width of 1-2 mm. Graft of necessary size for implantation between mucoperichondrial sheets is dissected from PPCA. The final stage of the operation is traditional nasal tamponade. Our research showed that during a week after the operation protein cover of autotransplant excrete platelet growth factors. These factors help in wound treatment and autotransplant integration between mucoperichondrial sheets. We performed 220 operations, 120 using our method and 100 of traditional septoplasty for control group. PPCA septoplasty showed better results and fewer after effects during post operation period than traditional methods. We did not register any cases of perforation, secondary septum deformation or hemorrhage and only one case of submucosal hematoma after tampon removal. Control group showed 3 cases of septum perforation, 7 cases of submucosal hematoma after tampon removal and 5 cases of respiratory dysfunction as a result of secondary septum deformation. Our results prove PPCA method of septoplasty to be reliable in any septum resection defect treatment, postoperative after effects prevention (septum flotation, septum perforation especially during intraoperational traumatic defects of mucous tunic). High secretion rate and adhesive ability of PGF helps in mucoperichondrial sheets treatment and submucosal hematoma prevention.
E-mail: krainik@hotmail.com
