Closure of septal perforations by means of 'external rhinoplasty'

Abstract

Objective. Evaluation of the ‘external rhinoplasty’ approach as a technique in the closure of septal perforations. Materials and methods. Ten patients with a septal perforation were studied. The average largest diameter ( sd ) was 1.48 cm 2 (0.39), as measured by lateral radiography after spreading the margins of the perforation with radiographic contrast fluid. Submucosal tunnels were made using a midcolumellar incision that was lengthened with marginal incisions, and the perforation was filled with aural cartilage. The extramucosalseparation of the upper lateral cartilages from the nasal septum allows the creation of a considerable mucosal flap in the nasal vault. By means of this transposition flap, together with a posterior based flap, all perforations could be covered. Results. Closure of nine septal perforations was successfully accomplished. Although it became smaller, one perforation persisted. Conclusion. The ‘external rhinoplasty’ approach provides a superior operative field. This visualization allows the formation of larger flaps. These advantages are translated into a greater success rate.