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Raol N, Olson K. A Novel Technique to Repair Moderate-Sized Nasoseptal Perforations. Arch Otolaryngol Head Neck Surg. 2012;138(8):714–716. doi:10.1001/archoto.2012.1204
Author Affiliations: Bobby R. Alford Department of Otolaryngology–Head and Neck Surgery, Baylor College of Medicine, Houston, Texas.
Objectives To describe a novel technique for closure of moderate-sized nasoseptal perforations and to review the current literature on various techniques for closure of nasoseptal perforations.
Design Retrospective review.
Setting Academic research.
Patients We performed a retrospective review of a successful novel technique that has been used at a facial plastic and reconstructive surgery practice for closure of nasoseptal perforations during 3 years (January 1, 2008, to January 1, 2011).
Main Outcome Measures Medical records were reviewed to identify patient characteristics, symptoms, causes of nasoseptal perforations, and outcomes, including patient satisfaction and rate of recurrent nasoseptal perforation.
Results During 3 years at our institution, 7 patients were identified with nasoseptal perforations that had been closed using bilateral mucosal advancement flaps (one inferiorly based flap advanced from the floor of the nose and another superiorly based flap advanced from the lateral nasal wall). The nasoseptal perforations ranged from 0.6 to 1.6 cm. Most patients had excellent outcomes, with resolution of symptoms and no recurrence.
Conclusions Nasoseptal perforations have traditionally been closed using 2 superiorly based flaps or 2 inferiorly based flaps. We present a novel technique combining both flaps for closure of moderate-sized nasoseptal perforations. This procedure decreases the risk for recurrence of the perforation, necrosis of the flaps, and development of a new perforation.
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