Amniotic Membrane as a Biologically Active Scaffold in Septal Perforation Repair: An Experimental Rabbit Study

To investigate the effect of amniotic membrane (AM), used alone or in combination with fascia lata (FL), on septal perforation healing in a rabbit model and to assess its potential as a biologically active scaffold for septal reconstruction.

Eighteen rabbits were randomized into three groups (FL, AM, and AM+FL). A standardized 5-mm full-thickness perforation was created in the anterior cartilaginous septum. Grafts were placed in a submucoperichondrial plane and secured with sutures. Animals were followed for 4 weeks. Primary outcome was complete perforation closure. Secondary outcomes included percentage reduction in perforation size and histopathologic healing parameters. Residual perforation size was quantified using digital image analysis, and histologic assessment was performed by a blinded histologist.

Sixteen rabbits completed follow-up. The AM+FL group demonstrated the greatest mean reduction in perforation size, whereas complete closure was observed in two animals in the AM group and one in the AM+FL group. Closure outcomes differed significantly between the FL and AM+FL groups (p=0.028). Histopathologic analysis showed significantly reduced epithelial and cartilage degeneration, acute inflammation, fibrosis, granulation tissue formation, and collagen deposition in AM-treated groups compared with FL alone (p<0.05). Chronic inflammation and regenerative parameters did not differ significantly.

Amniotic membrane, particularly when used as a biologically active scaffold with fascia lata, was associated with improved histopathologic healing parameters in this experimental model. These findings suggest that amniotic membrane may have potential translational relevance as an adjunct in septal perforation repair, although further experimental and clinical studies are required.

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