Nasal Septal Perforation Repair Techniques
Summary
Nasal septal perforation constitutes a full-thickness breach of the cartilaginous or bony septum and its mucosal linings, resulting in abnormal communication between the two nasal cavities. Patients may experience crusting, epistaxis, whistling or a sensation of nasal obstruction, with quality of life often significantly impaired. Small, asymptomatic defects can be managed conservatively with humidification and topical emollients, or closed temporarily with silicone buttons. Surgical repair aims to re-establish septal integrity and normal mucosal function, and a variety of approaches have been described. Autologous interposition grafts (cartilage, fascia) and local mucosal flaps (inferior or middle turbinate, septal) remain the mainstay for definitive closure. Recent innovations focus on multilayered reconstruction, preservation of vascular supply and the integration of synthetic or biologic scaffolds to support tissue regeneration. Image guidance and endoscopic techniques enhance intraoperative precision, while emerging regenerative strategies explore the use of stem cells and tissue-engineered constructs to promote mucosal restoration. The choice of technique is guided by perforation size, location and aetiology, balanced against patient factors and surgeon expertise.
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Nasal Septal Perforation Repair Techniques publication trend
The graph below shows the total number of articles in nasal septal perforation repair techniques across all publications each year (not limited to Nature Index journals).
Technical terms
Nasal septal perforation: A full-thickness defect of septal cartilage and mucosa creating an abnormal communication between the two nasal cavities.
Interposition graft: A reconstructive element—autologous cartilage, fascia or synthetic matrix—positioned between septal mucosal layers to bridge and support defect closure.
Turbinate flap: A local mucosal flap harvested from the inferior or middle turbinate, rotated into the septal defect while preserving its vascular pedicle.
Endoscopic measurement: The use of stereoendoscopic imaging combined with computer vision to capture accurate three-dimensional dimensions of septal perforations without the need for radiographic imaging.
References
- Sandwich graft technique outcomes in medium and large size nasal septal perforations. Brazilian Journal of Otorhinolaryngology (2021).
- Nasal Septal Perforation Repair with an Inferior Turbinate Flap and Acellular Dermal Matrix. The Surgery Journal (2021).
- Endoscopic measurement of nasal septum perforations. HNO (2021).
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