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A Novel Technique in Repair of Moderate-sized Nasal Septal Perforations

Objective: 1) Describe a novel technique which has been successful in closure of moderate-sized nasal septal perforations. 2) Review the current literature on various techniques that have been previously described for closure of nasal septal perforations. Method: Retrospective review of a successful technique used at our institution for closure of septal perforations over a 5-year span (2006-2010) at a facial plastic surgery practice. Charts were reviewed to find patient characteristics, symptoms, etiologies of perforation, and outcomes, including patient satisfaction and rate of recurrent perforation. Results: Over the past 5 years at our institution, 12 patients were identified with nasal septal perforations, which were 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 and upper lateral cartilage. The size of the perforations ranged from 0.6 cm to 1.6 cm. The majority of patients had excellent outcomes with resolution of symptoms and a low rate of recurrence. Conclusion: Nasal septal perforations have been approached traditionally with 2 superiorly based or 2 inferiorly based flaps. We present a technique with a combination of both flaps for closure of a moderate-size perforation. This decreases the risk of recurrence of the perforation, flap necrosis, and development of a new perforation.