Abstract: Objective To observe therapeutic effect of repairing nasal septum perforation with auto temporal fascia wrapping ethmoid perpendicular plate through endoscopic surgery. Methods Retrospective analysis of 50 cases of nasal septum perforation patient, among whom 30 cases were repaired by traditional surgery and 20 cases were repaired by sandwich surgery. All patients were examine by CT scan and nasal irrigation therapy were also performed through nasal endoscopy to improves nasal mucosa situation. Endoscopic procedures were performed in the traditional surgical group under local anesthesia, and septum mucosa was separated and shifted to repair septal perforation. On the other hand, temporal fascia of more than 2 times the diameter of the perforation were isolated then, wrapped around the perforation through front line of nasal incision after separating membrane of the nasal septum cartilage. Now， temporal fascia wrapping autologous ethmoid perpendicular plates form a rigid vertical "sandwich prosthesis" and were inserted into perichondrium of septal to repair perforation. Anti- infection and nasal moisturizing treatment were given after operation. Postoperative symptoms and the performance in follow-ups were recorded. Results Intraoperative blood loss (mL: 3.6±1.2 vs 13.4±2.9), operative time (min: 25.2±6.3 vs 46.5 ±10.3), mucosal damage range (mm2: 10.2±3.2 vs 20.5±5.3) and mucosal repair time postoperation (d: 19.5±3.9 vs30.2±3.1) were all less in sandwich group than those in traditional group (P < 0.05). Successful rate in sandwich group is also higher than that in the traditional surgical group (90.00% vs 46.67%, χ 2 =9.780, P <0.01) . No recurrence was found during follow-up from 6 months to 1 year in both groups. Conclusion Application of autologous temporalis fascia wrapping perpendicular plate of ethmoid bone to form a rigid "sandwich prosthesis" to repair nasal septal perforation by endoscopic surgery were effective. It can restore the normal anatomy of the nasal septum.

Key words: nasal septum perforation, endoscopic sinus surgery, temporal fascia, ethmoid perpendicular plate