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November 1968

Perforation of the Nasal Septum: The Reverse Flap Technique

Author Affiliations

From the departments of otolaryngology, University of Toronto Medical School, New Mount Sinai Hospital, and St. Joseph's Hospital, Toronto.

Arch Otolaryngol. 1968;88(5):518-522. doi:10.1001/archotol.1968.00770010520012

THE BUSY otolaryngologist does not find perforations of the nasal septum a rare entity. If the lesion is asymptomatic the patient may be unaware of its presence. The perforation may be viewed with passing curiosity in the course of a routine ear, nose, and throat examination.

Where symptoms exist because of a perforation there may be crusting, bleeding, and stuffiness. There may also be a deviation of the septum, commonly on the left side, and usually above the perforation under the nasal vault. This is probably because deviations of the septum, when present, occur more commonly on the left.

The simplest approach to therapy is to use a bland ointment to lessen the crusting and bleeding. This treatment usually has to be carried on indefinitely or the symptoms tend to recur. Where the lesion is not quiescent, the perforation edge shows raw cartilage and possibly bone, due to lack of