Clinical Medicine Insights: Ear, Nose and Throat

Aims: Surgical treatment of nasal septal perforation remains a challenging field of rhinology. A large variety of techniques and grafts with promising results have been introduced for perforation repair. However, the use of fascia or fascia with periosteum has not been previously evaluated for a large sample of patients.

Methods: During the years 2007–2014, 105 operations were performed and 98 patients were treated for nasal septal perforation at the Department of Otorhinolaryngology—Head and Neck Surgery, Helsinki University Hospital, Helsinki, Finland. We performed a retrospective review of closure rates and complications. Follow-up time ranged from 1 to 62 months.

Results: Bleeding was the most common early complication (9%), followed by postoperative infection (5%) in the whole series. Our main technique, bipedicled advancement flaps with fascia or fascia and periosteum, was performed for 81 patients. We obtained successful closure in 78% of these patients with this operative technique and the rate increased to 86% during the last 3 years of the study period.

Conclusions: Perforation repair with temporal fascia or fascia with periosteum requiring only one donor site seems to be a reliable option for nasal septal perforation repair.