Endoscopic closure of septal perforations

Area of Science:

• Otolaryngology
• Rhinology
• Surgical Techniques

Background:

• Septal perforations present a significant surgical challenge.
• Numerous surgical techniques exist, but evidence supporting a specific approach is lacking.
• Optimal management requires individualized case assessment.

Purpose of the Study:

• To offer a practical guide for selecting surgical techniques for septal perforations.
• To assist surgeons in choosing the most appropriate method based on specific case parameters.

Main Methods:

• Review of existing surgical techniques for septal perforation repair.
• Emphasis on pre-operative evaluation of perforation size, location, and osteo-cartilaginous support.
• Consideration of mucosal quality, patient history, and surgeon experience.

Main Results:

• Successful septal perforation repair hinges on assessing nasal mucosa, perforation dimensions, location, and osteo-cartilaginous integrity.
• Sliding or rotating septal mucosal flaps require prior knowledge of mucoperichondrium/mucoperiosteum elevation feasibility.
• Lateral wall or nasal floor flaps serve as alternatives; pericranial flaps are suitable for total/near-total perforations.

Conclusions:

• The remnant nasal septum and osteo-cartilaginous support are critical determinants in managing septal perforations.
• Individualized evaluation of perforation size, location, mucosal quality, and patient factors is essential.
• Surgeon experience plays a vital role in selecting the optimal surgical approach.