perforation repair 2.0

A video of stills explaining the surgical procedure I utilize to close a septal perforation. This procedure is done with loop magnification, not an endoscope, so it does not lend itself to a moving image. I have had a good success rate with this technique utilizing a rotation flap and acellular dermis. I have had failures with cartilage and temporalis fascia. We are limited in the size of perforation that can be closed - 2.5 to 3cm in the largest dimension. The limitation is that we need a donor site to move mucosa from - too large a hole means there is insufficient donor available.

Category:

Education

Tags:

• septal
• perforation
• nasal
• sinus
• turbinate
• septum
• hole
• closure
• rotation
• flap
• alloderm
• acellular
• dermis
• septoplasty
• silastic
• splint
• Steven
• Houser
• rhinology
• cleveland
• metrohealth

[shouser144]

3.5x1.5cm sounds too large to repair - there would not be enough "donor" tissue to slide into place and fix the hole. I am sorry.

[shouser144]

splints are used, not packing. Remember the size limits - i a perforation is too large it cannot be closed by this method, and perhaps by no method

[shouser144]

update: I removed her splints today (stayed in 4 weeks) and she is healing quite nicely. The exposed alloderm on the left has vessels growing into it giving it a mottled appearance at the edge. The right rotation flap is healthy and in good position.

[shouser144]

Rotation of a septal flap should not contribute to nor create ENS

[khalidaldarawy]

Hello i have a hole of about 3 cm or 3.5 cm long and 1.5 cm height, it is a big perforation, is there is anyway to close it ? it has been formed because of a failure surgery to correct my septum deviation !!!

[stevolica27]

Hi, this video is great. I have a nasal septal perforation of non-specific cause, but occurred around the time I had extra-intestinal manifestations of Inflammatory Bowel Disease. It has been trouble free for around 6 years and very healthy. Local ENT specialists here in Queensland, Australia seem to think reconstructions have a high failure rate, but I will be investigating further. My question is, do you have to pack the wound post-surgery??

[extremxx1]

Thank you for your response.

I very much appreciated your time.

[extremxx1]

Thank you very much for the video. I would like to kindly ask you please... by using this technique rotation flaps...is there any risk of becaming an Empty Nose Syndrome patient??? Will this surgery anyhow effect the function of nasal turbinates??