J Rhinol.  2019 May;26(1):38-42. 10.18787/jr.2019.26.1.38.

Two Cases of Septal Perforation Repair using Posterior Margin Based Hinge Flap

• Seo JH
• Kim SW
• Jeon YJ
• Cho HJ

• KMID: 2449027
• DOI: http://doi.org/10.18787/jr.2019.26.1.38

Abstract

Nasal septal perforation is a defect of cartilage, bone, or mucosa of the nasal septum. Nasal septal perforation has several potential causes such as previous septal surgeries, trauma, malignancy, inflammation, or drugs. According to previous studies, successful surgical outcome is affected by the size and location of the perforation. Although many surgical techniques have been reported, there is no standardized nor consistent surgical method for repairing nasal septal perforation. This report suggests a new surgical technique of repairing septal perforation using a posterior perforation-margin-based hinge flap.

Keyword

Nasal septal perforation; Surgical flap

MeSH Terms

Cartilage
Inflammation
Methods
Mucous Membrane
Nasal Septal Perforation
Nasal Septum
Surgical Flaps

Figure

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  Fig. 1 Preoperative endoscopic finding showed 1.7×1.5 cm sized septal perforation (IT: inferior turbinate, S: nasal septum).

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  Fig. 2 Computed tomography finding shows the septal perforation (1.7×1.5 cm) at anterior nasal septum (white arrow: septal perforation).

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  Fig. 3 Schematic diagram of the technique used in cases. A: Reverse C-shaped incision was made first. And then, retrogradely elevated mucosal flap was rotated and covered the right side defect. B: Advancement mucosal flap was used for closing the left side mucosal defect.

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  Fig. 4 Postoperative endoscopic view, septal perforation was completely closed after 12 months (A: right nasal cavity, B: left nasal cavity, IT: inferior turbinate, S: nasal septum).

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  Fig. 5 Preoperative endoscopic finding showed 1.2×0.5 cm sized septal perforation (IT: inferior turbinate, S: nasal septum).

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  Fig. 6 Postoperative endoscopic view, septal perforation was completely closed after 6 months (IT: inferior turbinate, S: nasal septum).

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