Perforations of the nasal septum following operative procedures

New operative methods have been introduced into nasal surgery in recent years; these are septoplastic, rhinoplastic and nasal reconstruction. These new methods are now employed together with the more traditional submucous septum resection. Today the above mentioned operations have been carried out in such large numbers that it is possible to commence comparing operative results. The present investigation is a comparison of the number of septum perforations with 1) submucous septum resection, 2) septum correction with reconstruction of the septum skeleton, and 3) septum correction in connection with rhinoplastic of the outer nose, possibly supplemented by nasal reconstruction. In the latter case a systematic suturing of all mucosal lacerations has been carried out, partly to prevent septum perforations and partly in order to keep the septum flaps intact during reimplantation of the cartilage and bone with the object of constructing a solid septum skeleton. While primary suturing of the mucosa is a relatively simple procedure, the closure of postoperative septum perforations is far more difficult. The results depend on the size of the perforation and the amount of cartilage and bone material still remaining in the septum. It must therefore be advisable to employ operative techniques which are able to prevent septum perforations or at least reduce their number to a minimum.