The surgical closure of nasoseptal perforations

Although nasoseptal perforations are uncommon--becoming even more so with early diagnosis and treatment of nasal trauma along with continuing refinements in septal surgery--a myriad of suggested techniques continue to exist for their closure. The conventional success rate is often unacceptably low so that Silastic prostheses are now being used to relieve the symptoms of septal perforation. The successful surgical closure of perforation of the nasal septum is still difficult. This treatment has been greatly facilitated by the use of the external rhinoplasty, without compromising the airway or causing cosmetic deformity. Supportive autogenous graft material is used routinely, while the perforation is closed using bilateral, bipedicled mucoperichondrial flaps. This paper omits a complete discussion of etiology. The indications for surgical correction are discussed in detail. The main contraindication to attempting correction is the size and the position of the perforation. The paper is based on 7 years' experience during which period 18 patients have had this surgery. The technical details of the operation are described with the aid of diagrams and photographs.