Treatment of Iatrogenic Septal Perforation with Conchal Cartilage

Abstract

Objectives: Septal perforation is one of the unwanted complications of septal surgery. The effects of perforation may change according to the location of the perforation, but anterior septal perforation may give rise to crusting and bleeding. Sometimes minor perforations may cause a whistling sound while breathing. Methods: We included 9 patients who had septal perforation caused by septal surgery. All perforations were located anteriorly and their diameter was between 2 and 3 cm. In one case, the septum was almost totally perforated, and we closed the perforation with auricular conchal cartilage. This study was done in Canakkale Military Hospital between 2010 and 2013. All subjects were males between the ages of 20 and 23 years. All had previously been operated on for septal deviation. Their main complaint was nasal stuffiness and epistaxis. An open approach rhinoplasty was done. In order to expose both septal perforation flaps, we separated upper lateral cartilages. The cartilage graft harvested from conchal cartilage was trimmed and sutured transseptally that fits perforation dimensions. Results: Nasal tamponade for stabilizing the graft were kept in place for 10 days. The graft stability was examined monthly for 3 months. The main criteria for surgical success was mucosal integrity and postoperative crusting in nasal passages. Eight of 9 cases were fully closed by conchal graft. In 1 case, the partially posterior part of the perforation was left open, but this perforation was asymptomatic. Conclusions: Auricular conchal graft usage in treatment of large septal perforations is an effective method.