Objective: 20 years after its first description, the bridge-flap technique according to Schultz-Coulon has proven to be the most successful method by far for the closure of nasoseptal defects. The number of nasoseptal defects being treated in Germany, and the treatment methods being used, are currently an unknown factor.
Material and methods: A questioning survey was sent to all 157 German ENT clinics. They were asked about the number of treatments of nasoseptal defects and the frequency of surgical techniques applied during 2007.
Results: 123 questionnaires were evaluated (return ratio=78.3%). In total, 777 nasoseptal defects were treated in Germany during 2007. 31 clinics treated no nasoseptal defects; at 71 clinics, 1-10, at 16 clinics, 11-20, and at 5 clinics, more than 30 nasoseptal defects were treated. 713 nasoseptal defects (91.8%) received surgical treatment, and 64 (8.2%) were treated by inserting a silicone button. With 556 patients (78%), the surgical closures of the nasoseptal defects took place with the help of the bridge-flap technique.
Conclusions: The survey data show a clear tendency towards the surgical care of nasoseptal defects at ENT clinics in Germany. In comparison to the previous school of thought that, in view of doubtful surgical results, symptomatic septal defects should be treated somewhat conservatively, a paradigm shift thereby took place. The fact that in the overwhelming majority of cases (78%), the bridge-flap technique according to Schultz-Coulon is used suggests that the favourable chances of success of this method are mainly responsible for the increasing surgical treatment of nasoseptal defects.