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Surgical Pearls
Jul/Aug 2018

Technique to Repair Total Septal Perforation With a Pericranial Flap: The Money Box Approach

Author Affiliations
  • 1Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
JAMA Facial Plast Surg. 2018;20(4):324-325. doi:10.1001/jamafacial.2017.2413

A total septal repair with pericranial flap (PCF) using the “money box approach”1 was carried out in a man in his 40s with septal perforation (52 × 34 mm) due to drug abuse (Figure 1). The technique can be viewed in Video 1 and Video 2. This report provides step-by-step guidance on how to rebuild a new nasal septum, highlighting key learning points and potential operative pitfalls.