Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-28T06:13:10.687Z Has data issue: false hasContentIssue false
  • English
  • Français

Use of N-butyl cyanoacrylate in nasal septoplasty: histopathological evaluation using rabbit nasal septum model

Published online by Cambridge University Press:  02 March 2010

F Aksoy ,
F Yılmaz ,
Y S Yıldırım ,
K Gideroglu  and
Z Tatar
F Aksoy
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, Haseki Research and Training Hospital, Istanbul, Turkey
F Yılmaz
Affiliation:
Department of ENT, Izzet Baysal Medical Faculty, Abant Izzet Baysal University, Bolu, Turkey
Y S Yıldırım*
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, Haseki Research and Training Hospital, Istanbul, Turkey
K Gideroglu
Affiliation:
Department of Plastic and Reconstructive Surgery, Izzet Baysal Medical Faculty, Abant Izzet Baysal University, Bolu, Turkey
Z Tatar
Affiliation:
Department of Pathology, Haseki Research and Training Hospital, Istanbul, Turkey
*
Address for correspondence: Dr Yavuz Selim Yıldırım, Haseki Egitim ve Arastirma Hastanesi, Kulak Burun Bogaz Klinigi, 34089 Fatih, Istanbul, Turkey. Fax: +90 212 5103701 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

This study was designed to investigate the effects of the tissue adhesive N-butyl cyanoacrylate on nasal septal tissues after septal surgery in a rabbit model.

Methods:

Forty-two adult New Zealand rabbits were randomly divided into three groups (14 in each group): septoplasty alone, septoplasty plus N-butyl cyanoacrylate, and controls. The open approach was used to explore the nasal septum. After raising mucoperichondrial and mucoperiosteal flaps on both sides of the septum, the septum was detached from the nasal floor in the septoplasty alone and septoplasty plus N-butyl cyanoacrylate groups. In the septoplasty plus N-butyl cyanoacrylate group, the mucoperichondrial and mucoperiosteal flaps were fixed to the septum and the septum was fixed lateral to the nasal spine using N-butyl cyanoacrylate; in the septoplasty alone group, the septum was packed with Merocel. In the control group, no further septal surgery was performed after flap elevation. Animals were observed for bleeding and haematoma formation over the first 24 hours. Seven animals in each group were used to evaluate early histopathological effects on the septal tissues, at four weeks post-operatively; the other seven in each group were used to evaluate late effects, at 12 weeks.

Results:

Haematoma formation was observed in 10 animals in the septoplasty alone group, in four animals in the control group, and in only one animal in the septoplasty plus N-butyl cyanoacrylate group. The difference in haematoma incidence between the septoplasty alone and the septoplasty plus N-butyl cyanoacrylate groups was significant (p = 0.000). Histopathological evaluation revealed no significant difference between the groups as regards granulation tissue formation at week four versus week 12; however, there was a significant difference between the septoplasty plus N-butyl cyanoacrylate group and the control groups as regards inflammation at week 12 (p = 0.038). There was a significant difference between the septoplasty plus N-butyl cyanoacrylate group and the septoplasty alone group as regards the composition of the bone–cartilage junction zone at week four (p = 0.001). There was also a significant difference between the septoplasty plus N-butyl cyanoacrylate group and the control group as regards the cellular structure of new cartilage formation at week 12 (p = 0.004).

Conclusions:

In this rabbit septoplasty model, N-butyl cyanoacrylate appeared to be an effective nasal tissue adhesive, with a low complication rate.

Keywords

Nasal SeptumSeptoplastyWound HealingTissue AdhesiveCyanoacrylate
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 7 , July 2010 , pp. 753 - 758
Copyright
Copyright © JLO (1984) Limited 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Kamami, YV. Laser-assisted outpatient septoplasty results on 120 patients. J Clin Laser Med Surg 1997;15:123–9CrossRefGoogle ScholarPubMed
2Watson, MG, Campbell, JB, Shenoi, PM. Nasal surgery: does the type of nasal pack influence the results? Rhinology 1989;27:105–11Google ScholarPubMed
3Bajaj, Y, Kanatas, AN, Carr, S, Sethi, N, Kelly, G. Is nasal packing really required after septoplasty? J Clin Pract 2008;63:757–9CrossRefGoogle ScholarPubMed
4Fairbanks, DN. Complications of nasal packing. Otolaryngol Head Neck Surg 1986;94:412–15CrossRefGoogle ScholarPubMed
5Suratt, PM, Turner, BL, Wilhoit, SC. Effect of intranasal obstruction on breathing during sleep. Chest 1986;90:324–9CrossRefGoogle ScholarPubMed
6Jones, J, MacRae, DL. Toxic shock syndrome. J Otolaryngol 1990;19:211–13Google ScholarPubMed
7Samad, I, Stevens, HE, Maloney, A. The efficacy of nasal septal surgery. J Otolaryngol 1992;21:88–91Google ScholarPubMed
8Nunez, DA, Martin, FW. An evaluation of post-operative packing in nasal septal surgery. Clin Otolaryngol Allied Sci 1991;16:549–50CrossRefGoogle ScholarPubMed
9Shermak, MA, Wong, L, Inoue, N, Chao, EY, Manson, PN. Butyl-2-cyanoacrylate fixation of mandibular osteotomies. Plast Reconstr Surg 1998;102:319–24CrossRefGoogle ScholarPubMed
10Dadas, B, Alkan, S, Cifci, M, Basak, T. Treatment of tripod fracture of zygomatic bone by N-2-butyl cyanoacrylate glue fixation, and its effects on the tissues. Eur Arch Otorhinolaryngol 2007;264:539–44CrossRefGoogle ScholarPubMed
11Bruns, TB, Simon, HK, McLario, DJ, Sullivan, KM, Wood, RJ, Anand, KJ. Laceration repair using a tissue adhesive in a children's emergency department. Pediatrics 1996;98:673–5Google Scholar
12Bozkurt, MK, Saydam, L. The use of cyanoacrylates for wound closure in head and neck surgery. Eur Arch Otorhinolaryngol 2008;265:331–5CrossRefGoogle ScholarPubMed
13Alkan, S, Dadas, B, Celik, D, Coskun, BU, Yilmaz, F, Basak, T. The efficacy of N-2-butyl cyanoacrylate in the fixation of nasal septum to the anterior nasal spine in rabbits: experimental study. Eur Arch Otorhinolaryngol 2007;264:1425–30CrossRefGoogle Scholar
14Toriumi, DM, O'Grady, K. Surgical tissue adhesives in otolaryngology-head and neck surgery. Otolaryngol Clin North Am 1994;27:203–9CrossRefGoogle ScholarPubMed
15Ellis, DA, Shaikh, A. The ideal tissue adhesive in facial plastic and reconstructive surgery. J Otolaryngol 1990;19:68–72Google ScholarPubMed
16Toriumi, DM, Raslan, WF, Friedman, M, Tardy, ME. Histotoxicity of cyanoacrylate tissue adhesives. A comparative study. Arch Otolaryngol Head Neck Surg 1990;116:546–50CrossRefGoogle ScholarPubMed
17Sachs, ME. Enbucrilate as cartilage adhesive in augmentation rhinoplasty. Arch Otolaryngol 1985;111:389–93CrossRefGoogle ScholarPubMed
18Quatela, VC, Futran, ND, Frisina, RD. Effects of cyanoacrylate tissue adhesives on cartilage graft viability. Laryngoscope 1993;103:798–803CrossRefGoogle ScholarPubMed
19Ozturan, O, Aktaş, D, Miman, MC, Kızılay, A. Use of histoacryl in functional cosmetic nasal surgery. Kulak Burun Bogaz Ihtis Derg 2000;10:9–13Google Scholar
20Laing, MR, Clark, LJ. Analgesia and removal of nasal packing. Clin Otolaryngol Allied Sci 1990;15:339–42CrossRefGoogle ScholarPubMed
21Illum, P, Grymer, L, Hilberg, O. Nasal packing after septoplasty. Clin Otolaryngol Allied Sci 1992;17:158–62CrossRefGoogle ScholarPubMed
22Yilmazer, C, Sener, M, Yilmaz, I, Erkan, AN, Cagici, CA, Donmez, A et al. Pre-emptive analgesia for removal of nasal packing: A double-blind placebo controlled study. Auris Nasus Larynx 2007;34:471–5CrossRefGoogle ScholarPubMed
23Leek, JH. Combined Merocel and Gelfilm as a nasal pack. Laryngoscope 1985;95:99CrossRefGoogle Scholar
24Hwang, JH, Liu, CM, Liu, TC, Hsu, MC. Sphenopalatine ganglion block before removal of nasal packing. Laryngoscope 2003;113:1423–4CrossRefGoogle ScholarPubMed
25Lavy, JA, Small, GV, Jay, N, Radcliffe, GJ. A prospective randomised controlled study of 4% lignocain solution in Merocel nasal pack removal. Rhinology 1996;34:219–21Google ScholarPubMed
26Thomas, DM, Samuel, D, Tierney, PA, Patel, KS. Audit of pain after nasal surgery. Ann R Coll Eng 1996;78:380–2Google ScholarPubMed
27Genç, E, Ergin, NT, Bilezikçi, B. Comparison of suture and nasal packing in rabbit noses. Laryngoscope 2004;114:639–45CrossRefGoogle ScholarPubMed
28Kuppersmith, RB, Atkins, JH, Tami, TA. The use of bioresorbable staples for mucoperichondrial flap coaptation in septoplasty. Otolaryngol Head Neck Surg 2009;140:599–600CrossRefGoogle ScholarPubMed