Microsurgical Repair of Large Nasal Septal Defects.

Area of Science:

• Otolaryngology
• Plastic Surgery
• Microsurgery

Background:

• Nasal septal defects, particularly large ones (>4-5 cm²), present significant reconstructive challenges.
• Traditional repair methods often yield suboptimal outcomes for extensive defects.
• Existing techniques struggle with large septal perforations, impacting patient morbidity.

Purpose of the Study:

• To evaluate the safety and efficacy of microsurgical reconstruction for large nasal septal defects.
• To assess the utility of engineered or prelaminated flaps in complex septal reconstruction.
• To identify key factors for successful outcomes in challenging septal defect repairs.

Main Methods:

• Retrospective review of nine patients with large nasal septal defects (>4 cm²).
• Treatment involved microsurgical reconstruction utilizing various engineered or prelaminated flaps.
• Data collected on defect size, etiology, flap type, and patient outcomes.

Main Results:

• Average defect size was 7.89 cm²; etiologies included cocaine use, neoplasm, and surgery.
• No flap losses occurred; all repairs were microsurgically reconstructed.
• Three patients experienced recurrent septal perforations (<1 cm), with two remaining asymptomatic.

Conclusions:

• Microsurgical reconstruction with engineered/prelaminated flaps is safe and effective for large nasal septal defects.
• Technical precision in flap inset is crucial for successful septal reconstruction.
• This approach offers a novel solution for challenging nasal septal defects.