title: Endonasal repair of septal perforations using a rotational mucosal flap and acellular dermal interposition graft.
abstract: BACKGROUND
  The closure of nasal septal perforations can be challenging based on the etiology, location, and method of closure. We report on a novel method of closure for nasal septal perforations using a unilateral mucosal rotational flap and acellular dermal interposition graft.
  
  
  METHODS
  Twenty patients with nasal septal perforations of various etiologies underwent our method of repair through a closed, endonasal approach.
  
  
  RESULTS
  Out of 20 patients, 17 demonstrated successful closure of their septal perforations, consistent with an 85% success rate. Based upon size, closure rates were 89% for small perforations (<1 cm), 80% for medium perforations (1-2 cm), and complete closure for a single large perforation (>2 cm). Of 20 patients, 19 were completely asymptomatic following surgical intervention, and of the 3 with failed repairs, only 1 patient required revision surgery for persistent symptoms.
  
  
  CONCLUSIONS
  Nasal septal perforations may cause bothersome symptoms and present a significant reconstructive challenge. Native septal tissue is advantageous due to a rich vascular supply and proximity to the defect, while interposition grafts act as a scaffold for the migration of respiratory mucosa. The method described herein combines these principles to provide a suitable technique for the closure of nasal septal perforations.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Nipun
authors.initials: N
authors.lastname: Chhabra
authors.forename: Steven M
authors.initials: SM
authors.lastname: Houser
mesh_terms: D000328:Adult; D020405:Dermis / Q000473:pathology / Q000637:transplantation; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000473:pathology / Q000637:transplantation; D061270:Nasal Septal Perforation / Q000601:surgery*; D009300:Nasal Septum / Q000473:pathology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012399:Rotation; D013524:Surgical Flaps; D019737:Transplants; D055815:Young Adult