Subperichondrial Surfactant Enhances Mucosal and Cartilage Healing in an Experimental Model of Nasal Septal Perforation

PURPOSE: To evaluate the effects of surfactant on mucosal and cartilage healing in an experimental nasal septal perforation model and to explore its potential as an adjunctive strategy in reconstructive surgery. METHODS: Twenty-eight adult female Wistar albino rats were randomly divided into 4 groups (n=7 each): control, sham, intranasal surfactant (study I), and subperichondrial surfactant (study II). Except for controls, a 2-mm full-thickness septal perforation was created. Study I received intranasal surfactant through Spongostan, whereas study II received subperichondrial surfactant injection around the perforation margins. On postoperative day 15, septal tissues were harvested and evaluated histopathologically for epithelial regeneration, inflammation, fibroblast and chondroblast activity, granulation tissue formation, cartilage regeneration, and vascularization, along with macroscopic closure. RESULTS: Subperichondrial surfactant administration resulted in significantly greater epithelial regeneration, increased chondroblast activity, enhanced cartilage regeneration, and more pronounced granulation tissue formation compared with the sham and intranasal groups (P<0.001). Inflammatory cell infiltration was significantly reduced in the subperichondrial group, whereas the highest levels were observed in the sham group (P<0.001). Complete macroscopic closure was achieved in all animals in the subperichondrial group (100%). No significant differences were observed in collagen deposition or vascular density among groups. CONCLUSION: Subperichondrial surfactant administration significantly enhances mucosal and cartilage healing and may represent a clinically relevant adjunctive strategy to improve outcomes in septal and craniofacial reconstructive procedures. LEVEL OF EVIDENCE: Experimental animal study.