Possibilities for nasal septum perforation healing: from the past to the future

Abstract

The article discusses application of various methods for nasal septum perforation healing (NSP). The types and options of surgical treatment in the historical aspect are described. These operations have a number of disadvantages, such as: the complexity of the material taking, the risk of inflammatory reaction and scar formation, as well as other postoperative complications leading to a relapse of the disease. Effectiveness of various allo- and autografts that used to restore the defect of the nasal septum is observed. Publications of regenerative medicine methods to eliminate perforation of the nasal septum are analyzed. Implantation of stromal cells, scaffolds; growth factors or their combinations is used. Such approaches make possible the restoration of the damaged tissue due to targeted and controlled cell differentiation, accompanied by the synthesis of the intercellular matrix and a decrease in inflammatory processes. In preclinical and clinical studies, special attention is paid to stromal cells. Mesenchymal stromal cells (MSCs) of bone marrow, adipose and other tissues are most often used. The regenerative effects of mesenchymal stromal cells are realized through the secretion of a wide range of anti-inflammatory mediators, cytokines and trophic factors, the positive effects of cell therapy of this type of cells should not be associated with the differentiation of implanted cells into cells of damaged tissues. The use of various materials for the treatment of NSP is also described with an assessment of their effectiveness and future prospects.