Surgical treatment of nasal septal perforations: SIR (Italian Society of Rhinology) experts opinion.
OBJECTIVE
The aim of our study has been to investigate the perception of aspects related to nasal perforation among experts in Rhinology and ENT surgeons. Our aim was reporting the situations in different Countries to improve the knowledge of colleagues interested in this topic.


METHODS
A panel of experts prepared a 20-question questionnaire regarding nasal perforations and their surgical repair, that were emailed to all the members of SIR (Società Italiana di Rnologia - Italian Society of Rhinology).


RESULTS
Data obtained from their answers showed that Cottle technique (64%) is the most common technique to perform septoplasty worldwide. 37% of the sample reported an occurrence of nasal septal perforation in less than 1% of patients and 75% attributed this occurrence to the skill of the surgeon, to infections, to drug use and to septal deformity. Trauma, pressure and Wegener's granulomatosis were also mentioned. The most common closure technique is the mucosal flap (75%), followed by the cartilage grafts (11%). Much less common were oral flaps, septal buttons and others. The majority agreed not to suggest septal perforation surgery in minimal (less than 3-4mm) perforations (73.5%), or limiting it to symptomatic patients (43.5%). The contraindications to repair surgery were reported to be: Wegener's granulomatosis, drug abuse, non-symptomatic perforation, its dimension and age of the patient. Septal deviation, atrophic rhinitis, smoke epistaxis and systemic diseases were also claimed. Failure in repair surgery has been observed to occur in less than 30% of cases.


CONCLUSIONS
Given the great difficulty to make random studies about controversial topics and obtain statistically significant data related to that, expert opinion shall be of great value (expert opinion, level of evidence 5).
ENT Clinic, Policlinico S. M. alle Scotte Siena, Italy. Electronic address: d.passali@virgilio.it.
Desiderio
D
Passali
ENT Clinic, Policlinico S. M. alle Scotte Siena, Italy.
Maria Carla
MC
Spinosi
ENT Clinic, Policlinico S. M. alle Scotte Siena, Italy.
Lorenzo
L
Salerni
ENT Clinic, Azienda Ospedaliera Universitaria di Foggia, Italy.
Michele
M
Cassano
ENT Clinic, Hospital Nacional de Pediatría Juan P. Garrahan, Buenos Aires, Argentina.
Hugo
H
Rodriguez
ENT Clinic, Policinico Tor Vergata, Roma, Italy.
Francesco Maria
FM
Passali
ENT Clinic, Policlinico S. M. alle Scotte Siena, Italy.
Luisa Maria
LM
Bellussi
D001291:Attitude of Health Personnel; D001294:Attitude to Health; D006801:Humans; D007558:Italy; D061270:Nasal Septal Perforation / Q000601:surgery*; D010036:Otolaryngology; D057566:Self Report; D012955:Societies, Medical
Cirugía de las perforaciones del tabique nasal; Nasal septal perforation surgery; Nasal septal perforations; Nasal septum; Perforaciones del tabique nasal; Tabique nasal