Endoscopic septal perforation repair by endonasal flap: a technique using mobilized septal bone or cartilage for support

PurposeSeptal perforation refers to a defect within the nasal septum, which subsequently creates communication between the two nasal cavities. More than one surgical approach has been described to repair nasal septal perforations; however, they have a high rate of complication. We aim to introduce a new technique of endoscopic repair of septal perforations, which supports the flap and is thus used to prevent commonly encountered complications.MethodsThis is a prospective cohort study with 40 patients who underwent thorough clinical examination, including nasal endoscopy, to determine the perforation details. This was followed by computed tomography (CT) scans and blood tests, which were done to exclude granulomatous disease, tumours, base of skull defects, polyps, etc. This new technique uses either a piece of cartilage alone or cartilage combined with a bone to support the flap. In the assessment, the perforation sizes were categorized, and a treatment plan was made for each.ResultsThe patients in the study were evaluated, and their most common complaint was crusting. Most patients with less than 1 cm perforations did not need support; the majority of those with 1-2 cm perforations required cartilage support, and 2-3 cm perforations required cartilage and bone support.ConclusionWe have proposed a new endoscopic technique that involves using cartilage and bone grafts to support the flaps used for nasal septal perforation repair and reduce the risk of associated complications.