Surgical Approach to
Septal Perforation Repair

A septal perforation is an opening in the nasal septum, the wall that divides the left and right nasal cavities.
It may occur following nasal surgery, trauma, repeated cauterization, chronic irritation, or other causes. In some cases, the underlying cartilage may be damaged.
The surgical approach to septal perforation repair varies depending on the size and location of the perforation:
· For small perforations (5 mm or less) with no other complications: The perforation may be repaired by elevating mucosal flaps on both sides of the septum,
advancing the tissue to close the opening, and placing silicone splints on both sides.
· For post-surgical perforations: Because there may be insufficient cartilage around the perforation, the central area may be
reinforced with graft materials such as cartilage or fascia.
· For large perforations (1 cm or larger): Repair may require a rotational mucosal flap, which involves elevating and rotating a mucosal flap from the nasal floor.
If the perforation is located in the anterior (front) part of the septum, it is more likely to cause symptoms and may enlarge over time.
Surgical repair may be recommended, particularly when symptoms are significant. In contrast, a posterior (back)
perforation may be visible on endoscopy but cause no symptoms, and surgery may not be necessary.

A septal perforation is an opening in the nasal septum, the wall that divides the left and right nasal cavities.
It may occur following nasal surgery, trauma, repeated cauterization, chronic irritation, or other causes. In some cases, the underlying cartilage may be damaged.
The surgical approach to septal perforation repair varies depending on the size and location of the perforation:
· For small perforations (5 mm or less) with no other complications: The perforation may be repaired by elevating mucosal flaps on both sides of the septum, advancing the tissue to close the opening, and placing silicone splints on both sides.
· For post-surgical perforations: Because there may be insufficient cartilage around the perforation, the central area may be
reinforced with graft materials such as cartilage or fascia.
· For large perforations (1 cm or larger): Repair may require a rotational mucosal flap, which involves elevating and rotating a mucosal flap from the nasal floor.
If the perforation is located in the anterior (front) part of the septum, it is more likely to cause symptoms and may enlarge over time. Surgical repair may be recommended, particularly when symptoms are significant. In contrast, a posterior (back) perforation may be visible on endoscopy but cause no symptoms, and surgery may not be necessary.