Repair of Nasal Septal Perforation by Intranasal Approach Using a Free Composite Graft of the Auricular Cartilage and the Temporalis Muscle Fascia

Hong, Soon Kwan; Min, Yang Gi

Abstract

BACKGROUND AND OBJECTIVES: The aims of this study are to introduce an intranasal repair technique of nasal septal perforation using a free composite graft of the auricular cartilage and the temporalis muscle fascia and to determine its efficacy by evaluating the treatment outcome. MATERIALS AND METHOD: Nine symptomatic patients (7 males and 2 females, aged 23 to 66 years) with nasal septal perforation were included in this study. They were all refractory to conservative treatments and they underwent surgery. Preoperative symptoms, etiology, size and location of septal perforations, and postoperative improvement of symptoms and perforations were retrospectively evaluated with a mean follow-up period of 21.7 months.
RESULTS
Preoperative symptoms included nasal obstruction, crust formation, rhinorrhea, epistaxis and foul odor. Septal perforation was assumed to have resulted in three patients from septal surgery, trauma and idiopathic causes, respectively. In all patients, the perforation size was 20 mm or less (mean: 12.2x8.4 mm) in diameter and located at the cartilagenous portion, not near the nasal dorsum. The perforations were completely repaired in 6 of 9 patients after surgery. Perforations of 1 and 3 mm in diameter remained in 2 and 1 of the 3 patients showing incomplete closure, respectively. However, clinical symptoms disappeared in 8 of 9 (88.9%) patients, postoperatively.
CONCLUSION
This technique may be an effective method for the repair of nasal septal perforation when the perforation is not located near the nasal dorsum and that its size is 20 mm or less in diameter, as the technique offers a cosmetic advantage and produces a satisfactory postoperative outcome by obviating difficulty in intranasal suture.