Two Nasal Septum Perforations, One Approximately 6x5 mm and the Other 2x1 cm – Before and 3-Months After
Treatment of Double Nasal Septum Perforation: Pre- and Post-operative Endoscopic Videos
Patient's Initial Examination and Evaluation of Septum Perforations
This patient had two separate septum perforations on the nasal septum, one approximately 6x5 mm and the other approximately 2x1 cm in size. These perforations developed after an open septorhinoplasty operation performed at another clinic, and the patient was subsequently referred to our clinic due to the perforations. Endoscopic nasal examination revealed dryness, crusting, and turbulence due to airflow at the perforation edges. Septum perforations can cause complaints such as dryness in the nose, crusting, bleeding, sound production during breathing, and decreased quality of life.
In the detailed pre-operative evaluation, the size, location, and condition of the surrounding tissues of the perforations were analyzed, and surgical planning was carried out.
Open Technique Septum Perforation Repair
The patient underwent open technique septum perforation repair under general anesthesia. The open approach allows for direct visualization of the perforation area and more precise tissue preparation. This method offers significant advantages to the surgeon, especially in medium and large perforations.
During surgery, mucosal tissues around the perforation were carefully freed, and bilateral mucosal flap techniques were used to close the perforations.
Use of Bone Nasal Septum Graft and Mucosal Flaps
Bone nasal septum tissue was used to support the perforations during the operation. The bone graft provides structural support in the perforation area, contributing to the healing of new tissues.
Mucosal flaps allow for closure of both surfaces of the perforation area with living tissue. This approach is one of the important surgical techniques that reduces the risk of re-opening the perforation while increasing long-term success rates.
Use of Internal Silicone Splints
Internal silicone splints were placed in both nasal passages to support mucosal healing and protect the surgical site after surgery. Silicone splints help maintain the stability of mucosal surfaces during the healing process while preserving the flaps.
During this process, the patient was advised to have regular nasal care and check-ups.
Endoscopic Examination 3 Months After Surgery
Three months after surgery, an endoscopic nasal examination performed after removal of the internal silicone splints showed that both septal perforations had successfully closed. The examination revealed healthy mucosal healing, a regular septal surface appearance, and complete closure of the perforation areas.
Significant improvement was observed in the patient's complaints of dryness, crusting, and breathing noises. It was assessed that the airflow inside the nose had become more physiological.
The Importance of Surgical Experience in Septal Perforation Repair
Nasal septum perforation repair is one of the most technically challenging operations in ENT surgery. The success rate; The success rate can vary depending on the size and location of the perforation, the surgical technique used, the quality of the tissue, and the postoperative care process.
Mucosal flap techniques supported by bone nasal septum grafts are among the reliable methods that can provide high success rates when appropriate patient selection is made.
Search result link where you can find articles prepared by Dr. Murat Enöz on nasal septum perforation and published on this website (you can also access previous articles by clicking "more posts" at the end of the page) >> https://www.ent-istanbul.com/search?q=nasal+septum+perforation
Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon
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