Endoscopic repair of nasal septal perforation with anterior ethmoidal artery flap using tunnel technique

PurposeSeptal perforations (SPs) present a distinct challenge. There are many described surgical approaches with variable success rates. The goal of this study is to describe a new technique in repairing SP.MethodsA case series of eighteen patients with anterior septal perforation who underwent endoscopic repair with the "tunnel technique" based on anterior ethmoid artery flap (AEA) were analyzed. Demographic data, etiology, size of perforation, and success rate were collected.ResultsEighteen cases with male predominance (67%) were enrolled from 2019 to 2022. The average perforation size was 1.5 cm (0.5- 3.6 cm). The success rate of complete SP closure was 94% (n = 17/18) with no complications after surgery. The patients were followed up for 7 +/- 5.2 months.ConclusionsAEA flap reconstruction with the tunnel technique is associated with favorable outcomes in SP closure. The tunnel technique provides a useful flap bolster and minimizes the use of other supportive measures. This technique offers an addition to other techniques for septal perforation repair.Level of evidenceLevel 4.