Kormilina A.R., Tukhbatullin M.G., Gilyalov M.N.
Perfusion ultrasound of the nasal septum (pilot study)
Keywords: perfusion ultrasound, nasal septum, nasal septum vascularization
The nasal septum is characterized by a highly developed capillary network that extends to the subepithelial layer. The capillaries of the subepithelial layer are inaccessible for visualization and determination of their hemodynamic parameters by routine methods. Commonly known methods of magnetic resonance imaging and perfusion computed tomography of the nasal septum allow for a detailed examination of all parameters of the submucosal haemodynamics of the capillary network. However, all these methods are expensive, not all clinics have sophisticated diagnostic equipment. During plastic surgery on the nasal septum, it is important to determine the parameters of blood flow at the submucosal, microvascular level. The aim of the study was to study the possibility of using perfusion ultrasound in determining vascularization parameters of the cartilaginous part of the nasal septum. Materials and methods. Perfusion ultrasound examination of the nasal septum was performed in 6 subjects (4 women, 2 men aged 36–49 years), 2 of them had no pathology of the nasal septum, 2 of them had perforation of the nasal septum, 2 of them had frequent nosebleeds. The basis of perfusion ultrasound examination of the cartilaginous portion of the nasal septum is an echocontrast study involving the intravenous bolus injection of 2 ml of the prepared SonoVue contrast agent suspension. The studies were performed on a Resona 7 ultrasound scanner (Mindray, China) using a linear sensor with a frequency of 6–10 MHz. A quantitative assessment of the kinetics of a contrast agent is presented as a graph (Time-intensity curve, Time-Intensity Curves – TIC). The following quantitative parameters were determined: TPI – time to peak intensity in seconds; TTSW – Time To Start Washing in seconds. Results. In optimal nasal septum vascularization, the time of peak accumulation (peak intensity) of contrast agent (TPI) and the time to start washing (TTSW) were in the ranges of 18.5–23 s and 25–28 s, respectively. The low degree of nasal septum vascularization corresponded to the time of peak accumulation of contrast (TPI) and the start of contrast washing (TTSW) in the ranges of 41–47 s and 50–53 s respectively. Conclusions. The conducted pilot study, perfusion ultrasound examination of the nasal septum, provides a significant determination of quantitative vascularization indicators – hemodynamics of capillaries of the submucosal layer of the nasal septum. The results obtained can be used in radiation diagnostics, otorhinolaryngology and maxillofacial surgery.
References
- Moldavskaya A.A., Khrappo N.S., Petrov V.V. Clinico-morphologicheskaya classificatsia podepitelialnogo microvasculyarnogo rusla zony Kisselbakha–Littla [Clinical and morphological classification of the subepithelial microvascular bed of the Kisselbach–Little zone]. Modern Problems of Science and Education, 2006, no. 3, pp. 19–21. Available at: https://science-education.ru/ru/article/view?id=296.
- Moldavskaya A.A., Khrappo N.S., Levitan B.N., Petrov V.V. Osobennosti organizatsii slizistoi obolochki i sosudistoi sistemy polosti nosa: Morfo-funktsional’nye i klinicheskie aspekty (obzor) [Features of the organization of the mucous membrane and vascular system of the nasal cavity: Morpho-functional and clinical aspects (review)]. Uspekhi sovremennogo estestvoznaniya, 2006, no. 5, pp. 18–22.
- Mosikhin S.B., Baranova E.A. Sposob diagnostiki gemodinamiki polosti nosa [Method for diagnosing hemodynamics of the nasal cavity]. Patent RF, no. 2299686.
- Proskurin A.I., Dorzhinova E.B., Grigorieva A.A. Sposob prognozirovaniya intraoperatsionnykh krovotecheniy [Method for predicting intraoperative nosebleeds]. Patent RF, no. 2407446.
- Tukhbatullin M.G., Gilyalov M.N., Kormilina A.R. et al. Sposob opredeleniya sostoyatelnosti peremechaemogo loscuta slizistoi obolochki peregorodki nosa [Method for Determining the Consistency of the Transferred Flap of the Nasal Septal Mucosa]. Patent RF, no. 2807147.
- Piskunov G.Z., Piskunov S.Z. Klinicheskaya rinologiya. 3-e izd., dop. [Clinical rhinology. 3rd ed.]. Moscow, MIA Publ., 2017, 750 p.
- Sukhanov V.A., Chernova O.N., Shubny M.O. et al. Sobstvennyi opyt provedeniya MRT T2 I CT perfuzii golovnogo mozga. Kak izbezhat “neudach” [Own experience of conducting MRI T2 and CT perfusion of the brain. How to avoid “failures”]. Ural Medical Journal, 2021, vol. 20, no. 2, pp. 43–48.
- Kharchenko V.V. Morfologiya sosudov pritoka razlichnykh zon slizistoi obolochki nosa [Morphology of inflow vessels of different zones of the nasal mucosa]. Rossiiskaya rinologiya, 2003, no. 2, p. 19.
- Gaillard F., Murphy A., Goel A. Dynamic contrast enhanced (DCE) MR perfusion. Radiopaedia org., 2017. DOI: 10.53347/rID-43781.
- Kridel R.W. Considerations in the etiology, treatment, and repair of septal perforations. Facial Plast Surg Clin North Am., 2004, vol. 12(4), pp. 435–450. DOI: 10.1016/j.fsc.2004.04.014.
- Sapmaz E., Toplu Y., Somuk B.T. A new classification for septal perforation and effect softreatment methods on quality of life. Braz J Otorhinolaryngol., 2019, vol. 85(6), pp. 716–723. DOI: 10.1016/j.bjorl.2018.06.003.
- Shcherbakov D.A., Kokareva V.V., Cheremnykh N.I., Shcherbakova A.F. Computational Aerodynamics in Nasal Septal Perforation. International Journal of Biomedicine, 2020, vol. 10(1), pp. 82–85. DOI: 10.21103/Article10.
About authors
- Kormilina Alsu R.
- Candidate of Medical Sciences, Associate Professor, Department of Ultrasound Diagnostics, Kazan State Medical Academy – Branch Campus of the Russian Medical Academy of Continuous Professional Education; Doctor, Department of Ultrasound No 1, Republican Clinical Hospital, Russia, Kazan (alsukormilina@gmail.com; ORCID: https://orcid.org/0000-0002-3549-4421)
- Tukhbatullin Munir G.
- Doctor of Medical Sciences, Professor, Head of Ultrasonic Diagnostics Department, Kazan State Medical Academy – Branch Campus of the Russian Medical Academy of Continuous Professional Education, Russia, Kazan (munir.tuhbatullin@tatar.ru; ORCID: https://orcid.org/0000-0002-0055-4746)
- Gilyalov Marat N.
- Candidate of Medical Sciences, Head of the Otolaringology Department, Republican Clinical Hospital, Russia, Kazan (gilyalov_m@mail.ru; ORCID: https://orcid.org/0000-0003-0903-5843)
Article link
Kormilina A.R., Tukhbatullin M.G., Gilyalov M.N. Perfusion ultrasound of the nasal septum (pilot study) [Electronic resource] // Acta medica Eurasica. – 2026. – №2. P. 13-20. – URL: https://acta-medica-eurasica.ru/en/single/2026/2/2/. DOI: 10.47026/2413-4864-2026-2-13-20.
Copyright holder: authors. License: Attribution 4.0 International (CC BY 4.0)
