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Published on: June 20, 2018
Cross-septal returned flap: modified endoscopic technique for bilateral closure of septal perforation
Y Rusetsky1, Z Mokoyan2, O Spiranskaya1
1Federal State Autonomous Institution "National Medical Research Centre of Children's Health", Russian Federation Ministry of Health, Moscow, Russia.
Insights
This study introduces a new endoscopic technique for nasal septal perforation repair. The cross-septal returned flap effectively achieves bilateral closure, restoring septal anatomy and reducing symptoms.
Area of Science:
- Otolaryngology
- Rhinology
- Surgical Innovation
Background:
- Endoscopic septal perforation closure is popular but often results in unilateral repair.
- Achieving complete, multilayer septal anatomy restoration remains challenging, especially in pediatric cases.
Purpose of the Study:
- To present a modified endoscopic technique for bilateral nasal septal perforation repair.
- To evaluate the efficacy of a novel cross-septal returned flap for septal perforation closure.
Main Methods:
- A modified endoscopic technique utilizing a novel cross-septal returned flap was performed on nine patients.
- Patients had nasal septal perforations with a mean size of 17.7mm (sagittal) and 16.9mm (vertical).
- Follow-up was conducted for a minimum of 12 months (12-31 months).
Main Results:
- The technique demonstrated high efficacy in closing nasal septal perforations bilaterally.
- Only one patient had a residual perforation, but with significantly improved symptoms.
- The cross-septal returned flap is indicated for perforations with non-epithelized edges.
Conclusions:
- The modified endoscopic technique using a cross-septal returned flap is highly effective for bilateral nasal septal perforation repair.
- This method allows for complete restoration of septal anatomy, particularly in challenging cases.
- The technique offers a viable solution for perforations unsuitable for traditional cross-over flaps.
Abstract:
Endoscopic approaches for septal perforation closure have achieved a certain popularity. Many of the flaps described provide unilateral closure of the perforation. Thus, complete restoration of the normal multilayer septal anatomy is still challenging, particularly in children. This article presents a modified technique for endoscopic bilateral surgical repair of nasal septal perforations. A novel cross-septal returned flap was performed in nine patients with nasal septal perforations. The mean size of the perforation was 17.7mm in the sagittal axis and 16.9mm in the vertical axis. All patients were followed up for a minimum of 12 months (range 12-31 months). There was only one case of residual septal perforation during the follow-up period, but with a significant decrease in the severity of symptoms. The results of the surgical technique presented show its high efficacy. We believe that the best indication for this technique is non-epithelized perforation edges that cannot be used as a reliable bridge for the preparation of any cross-over flaps. Use of the cross-septal returned flap allows the complete bilateral repair of nasal septal perforations to be achieved.
