[Concept and technique for closure of septum defects]

A surgical concept for the closure of perforations of the septum is presented. Small and medium-sized defects are closed by a one-step extramucosal technique also used in rhinoplasties. Tissue tubes of mucoperichondrium, mucoperiosteum and the upper lateral cartilage are mobilized in both nasal lumina. Parts of the lamina quadrangularis are dissected and shifted to close the defect. Very large defects with a diameter of more than 3 cm are closed in a three-step technique. A spoon-shaped flap from the oral vestibule with a piece of ear cartilage attached is inserted into the perforation. The cartilage is covered with oral mucosa on both sides. These procedures are superior to traditional techniques in terms of both blood supply and safe closure.