Septal perforation repair: mucosal regeneration technique

Abstract

A novel method for repair of septal perforations. Fifteen volunteers with symptomatic septal perforations were recruited. Open technique rhinoplasty approach was preferred: auricular conchal cartilage graft with intact perichondrium on both sides was harvested and shaped to fit the perforated site and attached to the septum with absorbable sutures. All margins of the graft were covered with nasal mucosa. The severity of patient symptoms was assessed at preoperation, 3 and 6 months postoperatively via visual analogue scale (VAS). Crust formation, whistling, nasal blockage, epistaxis and overall comfort were evaluated. Mucosal physiology was assessed by nasal mucociliary clearance time. The mean age of the patients was 47.3 years. Average perforation size was 1.86 ± 0.78 cm. 14/15 (93.3%) perforations were repaired, and only one patient required revision surgery. VAS scores improved significantly (p < 0.001). Mean mucociliary clearance time improved from 17.6 ± 3.83 to 10.3 ± 3.30 min and 9.3 ± 3.36 min at 3 and 6 months, respectively. This is a novel, simple and safe method for repairing the deficient mucosal area in septal perforations up to 25 mm in diameter.