Surgical outcome and complications of nasal septal perforation repair with temporal fascia and periosteal grafts

Clin Med Insights Ear Nose Throat. 2015 Apr 29:8:7-11. doi: 10.4137/CMENT.S23230. eCollection 2015.

Abstract

Aims: Surgical treatment of nasal septal perforation remains a challenging field of rhinology. A large variety of techniques and grafts with promising results have been introduced for perforation repair. However, the use of fascia or fascia with periosteum has not been previously evaluated for a large sample of patients.

Methods: During the years 2007-2014, 105 operations were performed and 98 patients were treated for nasal septal perforation at the Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Hospital, Helsinki, Finland. We performed a retrospective review of closure rates and complications. Follow-up time ranged from 1 to 62 months.

Results: Bleeding was the most common early complication (9%), followed by postoperative infection (5%) in the whole series. Our main technique, bipedicled advancement flaps with fascia or fascia and periosteum, was performed for 81 patients. We obtained successful closure in 78% of these patients with this operative technique and the rate increased to 86% during the last 3 years of the study period.

Conclusions: Perforation repair with temporal fascia or fascia with periosteum requiring only one donor site seems to be a reliable option for nasal septal perforation repair.

Keywords: infection; postoperative; reconstruction; septoplasty.