Septal perforation closure utilizing the external septorhinoplasty approach

Area of Science:

• Otolaryngology
• Surgical Techniques

Background:

• Nasal septal perforations present significant surgical challenges, especially when large or posteriorly located.
• Limited septal cartilage and bone further complicate closure with traditional methods.

Purpose of the Study:

• To evaluate the efficacy of the external septorhinoplasty approach for closing nasal septal perforations.
• To assess the success rate and symptomatic improvement using this technique.

Main Methods:

• Utilized external septorhinoplasty for direct access to the dorsal septum.
• Employed septal mucoperichondrial advancement flaps with grafts (mastoid periosteum, cartilage, ethmoid bone).
• Treated 22 patients with perforations up to 4 cm in diameter between 1981 and 1983.

Main Results:

• Achieved a 77% (17/22) complete closure rate for nasal septal perforations.
• Demonstrated significant symptomatic improvement in all treated patients.
• External approach facilitated closure of complex perforations otherwise difficult with intranasal methods.

Conclusions:

• External septorhinoplasty provides superior visualization and access for complex septal perforation repair.
• The combined technique of advancement flaps and grafting is effective for large septal perforations.
• This approach leads to high closure rates and patient symptom relief.