Dr. Isam Alobid (expert in septal perforation repair)
Conditions causing disruption of the adjacent septal bilateral mucoperichondrium often result in a necrosis of the underlying cartilage and septal perforations. The most common causes are: trauma (inappropriate septal surgery, habit-digit nasal, facial trauma and nasal foreign bodies), sarcoidosis, Wegener’s granulomatosis and tuberculosis, systemic lupus erythematosus, tumors and exposure to toxics (Figura 1).
Treatment of such perforations is still a surgical challenge includes not only close the defect, but also restore the laminar airflow and thus the normal nasal function. There is no uniform valid technique to close all perforations. However, the repairs are reported in publications as successful include, generally, flaps and muco-pericondrios interpositional grafts of cartilage or connective tissue. There have been various techniques for septal reconstruction such as: unilateral or bilateral especially large for advancement or rotation flaps, free grafts, inferior turbinate flap, vestibular flap, endonasal flaps and front flap for closing defects (Figura 2)(Figura 3) (Video Clip 1) (Video Clip 2) (Video Clip 3) (Video Clip 4) (Video Clip 5).