Nasal septal perforations must and can be closed

Area of Science:

• Plastic Surgery
• Otolaryngology
• Rhinology

Background:

• Cocaine abuse is increasingly causing septal perforations.
• Existing surgical techniques for septal perforations are often complex and underutilized.
• Effective repair of nasal septal defects is crucial for patient well-being.

Purpose of the Study:

• To describe and illustrate two sophisticated surgical methods for closing nasal septal perforations.
• To offer solutions for previously untreatable large septal perforations.
• To advocate for advanced techniques over obsolete local flaps.

Main Methods:

• A one-step repair for perforations up to 4 cm using mucoperichondrial/periosteal dissection, suture, and interposition of fascia or cartilage, potentially with buccal flaps.
• A three-step procedure for perforations larger than 4 cm, utilizing a composite buccal flap with ear concha cartilage.
• Techniques may involve alotomy or columellar base section to facilitate flap closure.

Main Results:

• The described methods provide effective closure for nasal septal perforations of various sizes.
• The one-step method addresses smaller defects, while the three-step method is designed for larger ones.
• These techniques aim to overcome the limitations of previous surgical approaches.

Conclusions:

• Advanced surgical techniques can successfully repair nasal septal perforations, including large defects.
• Plastic surgeons performing rhinoplasty should adopt these sophisticated methods.
• The described procedures offer improved outcomes for patients with septal perforations due to cocaine abuse.