a1 Department of Otorhinolaryngology and Head and Neck Surgery, Medical Faculty, Bezmialem Vakif University, Istanbul, Turkey
a2 Department of Otorhinolaryngology and Head and Neck Surgery, Elbistan State Hospital, Kahramanmaraş, Turkey
a3 Department of Otorhinolaryngology and Head and Neck Surgery, Haseki Research and Training Hospital, Istanbul, Turkey
a4 Department of Histology and Embryology, Faculty of Medicine, Istanbul University, Turkey
Aim: During nasal septum surgery, elevation of mucoperichondrium from the anterior nasal septum may be more difficult than from the medial and posterior septum. This study aimed to evaluate any histological structural differences between the anterior and posterior nasal septum cartilage, mucoperichondrium and intervening tissue.
Material and method: Unilateral mucoperichondrial flap elevation without infiltration was performed, after nasal tip and dorsum decortication, in four patients undergoing open septorhinoplasty. Full-thickness samples, including cartilage and mucoperichondrium, were removed from the anterior and posterior nasal septum and examined under light and electron microscopy.
Results: Light microscopy showed no difference between anterior and posterior septum specimens regarding perichondrial thickness and subperichondrial cell density. Demarcation between cartilage and perichondrium and between perichondrium and lamina propria was more regular in the posterior versus the anterior septum. Electron microscopy showed no difference in chondroblast activity at the two sites.
Conclusion: The observed tissue demarcation irregularities may explain the greater reported difficulty in elevating anterior versus posterior nasal septum mucoperichondrium. Immunohistochemical examination would further elucidate these interstructural connections.
(Accepted May 03 2011)
(Online publication September 05 2011)
c1 Address for correspondence: Op Dr Yavuz Selim Yıldırım, Elbistan Devlet Hastanesi Kulak Burun Boğaz Kliniği, 46300, Karaelbistan, Kahramanmaraş, Turkey Fax: +90 344 4138005 E-mail: firstname.lastname@example.org
Presented at the Annual Conference in the 33rd Year of The European Academy of Facial Plastic Surgery, 1–5 September 2010, Antalya, Turkey
Dr Y S Yıldırım takes responsibility for the integrity of the content of the paper
Competing interests: None declared