Bovine Pericardium Graft as a Salvage Option in Septoplasties at Risk of Septal Perforation

Background: Septoplasty is a widely performed surgical procedure to correct nasal septal deviations and improve respiratory function. One of its most significant complications is septal perforation, which can severely impact the patient's quality of life. This study evaluates the use of bovine pericardium grafts to enhance mucosal healing, thereby reducing the risk of postoperative septal perforation in cases with intraoperative bilateral mucosal defects. Methods: A retrospective study was conducted on patients who underwent septoplasty between January 2018 and January 2025 in whom bovine pericardium grafts were interposed due to the presence of bilateral opposing mucosal defects. Epidemiological and surgical variables were recorded, and outcomes and complications were analyzed. Results: Out of the 4151 septoplasties performed, 30 cases (0.72%) required bovine pericardium interposition. The mean patient age was 42.87 years. Postoperative absence of septal perforation was confirmed in 90% of cases, with only three postoperative perforations, all asymptomatic and approximately 2 mm in size. Complications were recorded in three patients (10%), all of which were resolved with conservative treatment and without sequelae. Conclusions: For the first time in routine surgical practice, bovine pericardium emerges as a viable option for preventing postoperative septal perforation in cases with bilateral opposing mucosal defects. With a high closure rate and a low incidence of adverse events, this material represents a promising tool in septal surgery.