Surgical closure of nasal septal perforation using mucosal flaps and interposed graft: a case series of 154 patients and literature review

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Background Nasal septal perforations are defects of the septum. Symptomatic patients failing conservative measures may be considered for surgery; however, the surgery is challenging. This study describes a technique involving mucosal advancement flaps and autologous or acellular porcine interposition grafts and assessed the long-term closure rate and symptom control. Method This study looked at patients with symptomatic septal perforations who underwent surgery between 2005 and 2017. Symptoms were assessed pre- and post-operatively using a visual analogue scale. A literature search was performed for septal perforation repair techniques and outcomes. Results A total of 95 per cent of patients had complete closure of their septal perforations, 90 per cent had complete symptom control. There were statistically significant differences between the pre- and post-operative mean visual analogue scale score for epistaxis ( p < 0.001), crusting ( p < 0.001), whistling ( p < 0.001) and nasal obstruction ( p < 0.001). Conclusion Surgical closure of nasal septal perforations with mucosal advancement flaps and an interposition graft is a reliable technique with excellent long-term outcomes.