Anteriorly-based nasal floor mucoperiosteal flap for septal perforation

BACKGROUND: Rhinologists frequently encounter challenging cases of septal perforation, and to date, no definitive consensus exists regarding the most appropriate surgical technique. METHODS: The study included adult patients with anterior septal perforation. All patients underwent a general and ear-nose-throat examination (including upper airway endoscopy) as well as computed tomography of the nose and paranasal sinuses. The endoscopic unilateral anteriorly-based nasal flap procedure was performed under general anesthesia. RESULTS: Fourteen patients with anterior septal perforations measuring 11-25 mm in diameter were included. The procedure was performed smoothly without intraoperative complications, with operative times ranging from 40 to 70 minutes. The follow-up period ranged from 6 to 14 months. Postoperative pain was minimal and well tolerated. Nasal crusting was mild and resolved almost completely within 2 weeks. By the end of the first postoperative month, no patient reported nasal obstruction. Complete resolution of preoperative symptoms occurred in 12 of 14 patients (85.7%), while the remaining two patients (14.3%) experienced symptomatic improvement. CONCLUSION: The anteriorly-based nasal floor mucoperiosteal flap yields favorable outcomes in patients with septal perforation, with minimal morbidity.