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Pediatric Septal Perforation Repair With the Endoscopic Anterior Ethmoid Artery Flap
Samih J Nassif1, Andrew R Scott1,2
1Department of Otolaryngology-Head and Neck Surgery, Tufts Medical Center, Boston, Massachusetts, USA.
Insights
A minimally invasive endoscopic technique using an anterior ethmoid artery flap successfully repaired nasal septal perforations in children. This approach offers a new, effective treatment option for pediatric nasal septal defects.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Endoscopic Sinus Surgery
Background:
- Pediatric nasal septal perforations cause symptoms like obstruction and bleeding.
- Current surgical repairs often involve combined endonasal and external approaches.
- Definitive repair is typically delayed until early adulthood.
Observation:
- This study reports on 3 children (ages 12-13) with nasal septal perforations (6-12 mm).
- A purely endoscopic anterior ethmoid artery flap technique was employed.
- This flap is an established method for adult septal perforation repair.
Findings:
- Successful closure of septal perforations was achieved in all 3 pediatric patients.
- The endoscopic anterior ethmoid artery flap technique proved effective.
- All patients experienced complete symptom resolution post-surgery.
Implications:
- The anterior ethmoid artery flap may be a viable surgical option for pediatric septal perforations.
- This endoscopic technique can be performed in children as young as 12 years.
- It potentially avoids the need for additional procedures like turbinate translocation.
Abstract:
Pediatric nasal septal perforations can lead to crusting, obstruction, whistling, and recurrent epistaxis. Current approaches for pediatric nasal septal repair center on combination endonasal and external approaches. Herein we describe the successful utilization of a purely endoscopic anterior ethmoid artery flap, an established technique in adults, for nasal septal perforation repair in 3 children aged 12 to 13 years who presented with septal perforations ranging in size from 6 to 12 mm. Successful closure was achieved with an endoscopic anterior ethmoid artery flap, with all patients achieving complete closure and symptom resolution. Children with nasal septal defects are typically treated with temporizing measures until early adulthood, when definitive open repair may be performed. Our initial experience with the anterior ethmoid artery flap technique suggests that this surgery may be easily performed in children as young as 12 years, without the use of previously described adjunctive procedures such as turbinate translocation.
