[Long-term results after surgical closures of septal perforations]

The surgical closure of a nasal septal perforation (SP) is a technically difficult operation, which requires a great deal of experience of the surgeon. Amazingly, the success rate in the literature is given as about 90%. In these studies, the retrospective follow up is generally very short. Therefore, the aim of this study was to examine the late results of surgical closures of SP in a combined prospective, consecutive observational study. Material und Methods: From 2000 to 2010 a total of 348 patients received a surgical closure of a SP by using bridge flaps, open / closed approach, with / without interposition of ear cartilage. 200 patients were included. In 187 patients a complete closure has been planned. 109 (58%) had undergone previous nose surgery. The median follow-up between surgery and last examination was 67 months (12 to 144).

A long-term closure of the SP was achieved in 72% (n=134). In 28% (n=53) a recurrence occurred. In 13 patients, only a partial closure based on the size of the SP was carried out. Factors influencing success rates as well as the current literature are discussed.

The success rates reported in the literature of more than 90% appear to be very high. This study demonstrates that high long-term success rates are very difficult to achieve even in rhinosurgical centres. Deviations from results of other studies can be explained by very short follow-up periods and a retrospective study design in almost all cases. An appropriate informed consent of the patient before surgery is important in order to achieve realistic expectations.