The management of septal perforations

Twenty-five patients with septal perforations were seen between July 1, 1983, and June 30, 1989. There were 16 males and 9 females, who ranged in age from 21 to 72 years, with the median age of 41.7 years. The majority of the perforations were traumatic in origin, with 19 cases seen following septal surgery, and were between 1.5 and 2.5 cm (20), with a range of 0.5 to 4 cm. All were located at the posterior border of the quadrilateral cartilage at the vomer-ethmoid junction. All but 3 patients underwent surgical repair, and successful closure was achieved in all but 3. However, only 1 patient remained symptomatic after surgery. The surgical technique employed includes an external rhinoplasty approach, septal and intranasal mucosal flaps, and an autograft of mastoid periosteum or temporalis fascia.