Septal Perforation Repair Using Bilateral Rotational Flaps With Interposed Mastoid Periosteal Graft.

Area of Science:

• Otolaryngology
• Rhinology
• Surgical Techniques

Background:

• Septal perforations can significantly impact quality of life.
• Surgical repair aims to restore nasal function and integrity.
• Endonasal approaches offer minimally invasive options for septal perforation closure.

Purpose of the Study:

• To evaluate the efficacy of endonasal repair of septal perforations.
• To assess outcomes using opposing bilateral rotational flaps and a periosteum interposition graft.
• To identify factors influencing successful septal perforation repair.

Main Methods:

• Retrospective review of 104 patients undergoing septal perforation repair by a single surgeon.
• Exclusion criteria included cocaine use and positive anti-neutrophil cytoplasmic antibodies (ANCA).
• Data collected included demographics, perforation etiology, closure rates, and complications.

Main Results:

• The overall success rate for septal perforation repair was 87.5% at 6-month follow-up.
• Successful closure rates varied by etiology: 95.6% for prior surgery, 86.7% for trauma, and 79.5% for unknown causes.
• Average perforation sizes ranged from 1.25 cm to 1.35 cm across etiologic groups, with repairs up to 1.5 cm.

Conclusions:

• The described endonasal technique provides reliable outcomes for septal perforations up to 1.5 cm.
• An unknown etiology of septal perforation appears to be a risk factor for repair failure.
• This approach offers a predictable solution for managing septal perforations.