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Subject Area

Ophthalmology

Article Type

Original Study

Abstract

Objective To assess the outcome of endoscopic superiorly based septal mucosal flap technique in the repair of nasal septal perforation. Background Septal perforations are a common problem with many surgical options for closure using either closed or open approach. Patients and methods This case series study included 14 patients with anterior septal perforation with idiopathic or iatrogenic etiology recruited from Otorhinolaryngology Department, Menoufia University, during the period from July 2015 to July 2017. The patients were assessed using history taking, anterior rhinoscopy, endoscopic examination, and computed tomography. Preoperative symptoms were assessed using visual analog scale. All patients were subjected to superiorly based septal mucosal flap. The success rate was assessed with operative duration, operative blood loss, and postoperative symptom scores. The success of the operation was correlated with vertical and anteroposterior diameters of the perforation. Results The success rate of the technique was 71.4%. The mean operative duration was 2.23 ± 0.44 h. The mean blood loss was 93.6 ± 13.9 ml. There was a highly significant improvement in all symptom scores except for whistling, which showed a significant improvement (P < 0.001 and P = 0.002, respectively). There was a significant relationship between the success of the operation and the anteroposterior diameter (P = 0.002) but not the vertical diameter (P = 0.7). Conclusion Our flap technique is a new and good option for repair of septal perforations with a success rate of 71.4%. It is most effective with limited anteroposterior diameters. Large anteroposterior diameters need other flap designs or an open approach.

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