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Letters to the Editor
June 2013

Nonopposing Suture Lines in Nasal Septal Perforation Repairs

Author Affiliations

Author Affiliation: Department of Otolaryngology–Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.

JAMA Otolaryngol Head Neck Surg. 2013;139(6):657. doi:10.1001/jamaoto.2013.3380

I appreciate the article “A Novel Technique to Repair Moderate-sized Nasoseptal Perforations,” by Raol and Olson1; however, I must point out that the described technique is simply a modification of the procedure described by Fairbanks2 in 1980 and revisited by Kridel et al3 in 1986, Arnstein and Berke4 in 1989, and Ambro et al5 in 1993. Raol and Olson1 have omitted the inferiorly based flap on 1 side of the perforation repair—this is a common practice among surgeons repairing perforations through an open rhinoplasty approach when adequate mucoperichondrium is available to repair 1 side of the perforation from above. Raol and Olson1 note that the main advantage of the technique is the bilateral closure with nonopposing suture lines—nonopposing suture lines are a feature of the technique originally described by Fairbanks.2 Finally, Figure 4 does not accurately reflect the technique that is described for perforation closure. This illustration depicts overlapping mucoperichondrial flaps, whereas the text correctly describes flaps sutured together along their edges.

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