Repair of large nasal septal perforations (NSP) can be challenging due to limited availability of surrounding nasal tissue, mucosal tension and diminished vascularity. The authors of this manuscript included 38 studies involving 408 patients with large NSP, with aetiologies ranging from idiopathic, iatrogenic, trauma and drug use. Commonest aetiology was iatrogenic (61.2%) and commonest symptom was nasal obstruction (62%). Success rate of 91.8% was reported with pedicled/composite flaps and implants versus 88.2% for mucosal advancement, 86.6% for interpositional grafts and 72.7% for graft-flap combinations. Failures were seen mainly due to reperforations with mucosal advancement, while inability to close primarily lead to failure of interpositional grafts and combination repairs. The authors conclude that strongest predictor of failure was the large size of the NSP.
Large septal perforation repair
Reviewed by Gauri Mankekar
Surgical repair of large nasal septal perforation: a systematic review and meta-analysis.
CONTRIBUTOR
Gauri Mankekar
Department of Otolaryngology-Head Neck Surgery, Louisiana State University Shreveport, Louisiana, USA.
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