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Original Article | ONLINE FIRST

A Novel Technique to Repair Moderate-Sized Nasoseptal Perforations

Nikhila Raol, MD; Krista Olson, MD
Arch Otolaryngol Head Neck Surg. 2012;138(8):714-716. doi:10.1001/archoto.2012.1204.
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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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Figures

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Grahic Jump Location

Figure 1. Incision on the left in the anteroposterior direction at the attachment of the inferior turbinate to the lateral nasal sidewall.

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Grahic Jump Location

Figure 2. Following elevation of the flap off the floor of the nose, the flap is rotated and advanced into position to cover the nasoseptal perforation on the left.

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Grahic Jump Location

Figure 3. Incision on the right at the junction of the upper lateral cartilage and the septum or from the medial surface of the upper lateral cartilage.

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Grahic Jump Location

Figure 4. Following elevation of the flap off the right lateral nasal sidewall, the flap is rotated and advanced into position to cover the nasoseptal perforation on the right.

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