Endoscopic Repair of Septal Perforation Using a Double-Layer Fascia Lata Technique

Septal perforation repair remains technically challenging, particularly in defects requiring stable graft support for closure. We describe an endoscopic double-layer fascia lata technique and report surgical outcomes in a consecutive case series. Adult patients who underwent endoscopic septal perforation repair between 2022 and 2024 were reviewed, and 26 patients with perforations >1 cm were included. Perforations were measured in anterior-posterior and cranio-caudal dimensions, and graft size was determined according to the longest diameter. A fascia lata graft harvested from the thigh was folded to create a double-layer construct and secured with an absorbable suture. The graft was placed beneath the elevated mucoperichondrial flap and stabilized with bilateral splints for approximately 3 weeks. Complete closure was achieved in 24 patients (92.3%), while 2 patients with perforations ≥4 cm had partial closure. No perioperative or postoperative complications were observed.