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Bansberg et al. Plast Aesthet Res 2024;11:12 Plastic and
DOI: 10.20517/2347-9264.2023.109
Aesthetic Research

Original Article Open Access

Septal perforation

Stephen F. Bansberg, Amar Miglani
Department of Otolaryngology-Head & Neck Surgery, Mayo Clinic in Arizona, Phoenix, AZ 85054, USA.
Correspondence to: Dr. Stephen F. Bansberg, Department of Otorhinolaryngology-Head & Neck Surgery, Mayo Clinic in Arizona,
5777 E. Mayo Boulevard, Phoenix, AZ 85054, USA. E-mail: Bansberg.stephen@mayo.edu

How to cite this article: Bansberg SF, Miglani A. Septal perforation. Plast Aesthet Res 2024;11:12. https://dx.doi.org/10.20517/
2347-9264.2023.109

Received: 10 Nov 2023 First Decision: 15 Mar 2024 Revised: 29 Mar 2024 Accepted: 8 Apr 2024 Published: 15 Apr 2024

Academic Editor: Marten Basta Copy Editor: Yanbing Bai Production Editor: Yanbing Bai

Abstract
Aim: This study isolates septal perforations due to nasal surgery for clinical analysis and their effect on bilateral
mucosal flap repair.

Methods: This is a retrospective review of a single surgeon’s 20-year experience with endonasal perforation repair
utilizing bilateral mucosal advancement flaps supported with an autologous tissue interposition graft. Patients with
a minimum of 4-month postoperative follow-up were included in the study. Comparative analyses of repair failure
rates and perforation size of failures between surgical and non-surgical etiologies were performed.

Results: Three hundred ninety-two patients met the criteria for inclusion in the study. The incidence of perforation
and prior septal surgery was 40.6%. Overall repair closure in patients with a minimum of 4 months follow-up was
94.8%. Failures were noted in 5.7% of surgical and 4.7% of non-surgical perforation etiologies (P = 0.816). Mean
differences in perforation length and height in failed repairs between non-surgical and surgical etiologies
(19.4 vs. 13.7 and 15.5 vs. 9.3 mm, respectively) were significant (P = 0.048 length, P = 0.006 height).
Conclusion: Post-surgical nasal septal perforations can be repaired with a low rate of failure. However, this study
found that the size of perforations in failed repairs was significantly smaller in patients with a history of septal
surgery, suggesting that prior septal surgery increases the technical difficulty of a bilateral flap perforation repair.

Keywords: Septal perforation, complications, septal surgery, mucosal flap repair

© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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