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Updated: May 24, 2026
Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Endonasal repair of septal perforations using a rotational mucosal flap and acellular dermal interposition graft
Nipun Chhabra1, Steven M Houser
1Department of Otolaryngology-Head and Neck Surgery, Case Western Reserve University, Cleveland, OH, USA.
Background:
The closure of nasal septal perforations can be challenging based on the etiology, location, and method of closure. We report on a novel method of closure for nasal septal perforations using a unilateral mucosal rotational flap and acellular dermal interposition graft.
Methods:
Twenty patients with nasal septal perforations of various etiologies underwent our method of repair through a closed, endonasal approach.
Results:
Out of 20 patients, 17 demonstrated successful closure of their septal perforations, consistent with an 85% success rate. Based upon size, closure rates were 89% for small perforations (<1 cm), 80% for medium perforations (1-2 cm), and complete closure for a single large perforation (>2 cm). Of 20 patients, 19 were completely asymptomatic following surgical intervention, and of the 3 with failed repairs, only 1 patient required revision surgery for persistent symptoms.
Conclusion:
Nasal septal perforations may cause bothersome symptoms and present a significant reconstructive challenge. Native septal tissue is advantageous due to a rich vascular supply and proximity to the defect, while interposition grafts act as a scaffold for the migration of respiratory mucosa. The method described herein combines these principles to provide a suitable technique for the closure of nasal septal perforations.
