Modified 'cross-stealing' repair of nasal septal perforation using unilateral inverted mucosal flap

Nasal septal perforations (SP) are common yet challenging conditions encountered in otorhinolaryngology. Endoscopic repair of nasal septal perforations using nasal pedicle mucosal flaps has become an important treatment method. However, there are no established guidelines for selecting the appropriate mucosal flaps for repair, and the choice largely depends on the surgeon's experience. This study outlines the procedure and benefits of utilizing a unilateral inverted mucosal flap from the nasal septum, along with criteria for selecting suitable cases for this surgical approach. The technique is best suited for moderate-sized perforations located in the anterior nasal septum, with a diameter of less than 2cm. The mucosa around the perforation is thicker. It is essential that the nasal mucosa is healthy and that the perforation edges have sufficient bony and cartilaginous support to prevent mucosal adhesion on both sides of the septum, which could hinder the complete separation of the inverted mucosal flap. Our findings suggest that, with careful case selection, the repair technique involving a unilateral inverted mucosal flap combined with stitching methods is a feasible option. This approach not only simplifies the surgical procedure but also significantly reduces its complexity, making it more accessible to those new to the field.