Related Experiment Video
Updated: Jul 9, 2026
Donor Posterior Atrial Flap Rotation for Left Atrial Cuff Reconstruction in Lung Transplantation
Published on: October 11, 2024
Superior Labial Artery Flap for Septal Perforation Repair: The Boxer's Flap
Nicholas J Campion1,2, Zhanna Mokoyan3, Viktoriya Stepanova4
1Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia.
This study introduces a novel surgical technique using a superior labial artery (SLA)-based nasal floor flap for repairing anterior nasal septal perforations (NSPs). The flap demonstrated high success rates in achieving anatomical closure and significant symptom relief, offering a viable solution when other methods fail.
Area of Science:
- Otolaryngology and Head and Neck Surgery
- Surgical Innovation in Rhinology
- Anatomical Flap Reconstruction
Background:
- Anterior nasal septal perforations (NSPs) present significant challenges in repair, particularly in revision cases due to compromised septal mucosal integrity.
- Traditional repair methods using anterior ethmoid or greater palatine artery flaps may not be feasible in complex or revision settings.
- A need exists for alternative reconstructive techniques that offer reliable closure and symptomatic improvement for challenging NSPs.
Purpose of the Study:
- To describe a novel surgical technique utilizing an anteriorly pedicled nasal floor mucoperiosteal flap based on the superior labial artery (SLA) for NSP repair.
- To evaluate the anatomical and symptomatic outcomes of this SLA-based flap in patients unsuitable for traditional flap methods.
- To assess the efficacy of this technique in achieving closure and improving patient-reported outcomes.
Main Methods:
- A case series of consecutive adult patients undergoing endoscopic NSP repair with an SLA-based anterior pedicled floor flap was conducted.
- Outcomes were assessed through anatomical closure, Miglani endoscopic score, and symptom evaluation using the SNOT-22 and nasal subdomain scores.
- Success was defined by both complete anatomical closure and resolution of clinical symptoms.
Main Results:
- Twenty-one patients with a mean age of 41.5 years were followed for an average of 9.4 months.
- The majority of perforations were anterior (85.7%) and iatrogenic, with a mean area of 92.6 mm².
- High rates of complete success (anatomical closure and symptom resolution) were achieved in 90.5% of cases, with significant improvements in endoscopic scores and patient-reported symptoms (p < 0.001).
Conclusions:
- The SLA-based nasal floor flap is a highly effective technique for repairing anterior nasal septal perforations.
- This flap offers high anatomical closure rates and significant symptomatic improvement, especially in cases where traditional septal flaps are not feasible.
- The technique provides a valuable reconstructive option for challenging NSP cases, enhancing patient quality of life.