Septal perforation repair, 10 years experience at the Clinical Hospital of University of Chile

Abstract

Introduction: Septal perforation corresponds to a discontinuity of the nasal septum. Various etiological factors are involved, influencing the treatment, and several surgical techniques have been described for its resolution.

Objectives: Report clinical and demographic characteristics, techniques used, and surgical outcomes of patients who underwent septal perforation closure at the Clinical Hospital of the University of Chile (HCUCH).

Materials and Methods: A retrospective cohort study was conducted, including patients with surgically septal perforation resolved at HCUCH between the years 2013 and 2023.  

Results: Eighteen patients and 20 surgeries were included. The main reported symptoms were nasal obstruction and recurrent epistaxis. 45% were secondary to septoplasty, and 35% were due to nasal trauma. 70% were classified as medium or small in size, with 30% classified as large. The most used techniques were: anterior ethmoidal artery flap (AEAf) (35%), followed by unilateral mucosal advancement (30%). Multiple grafts were used, with the most frequent being inferior turbinate mucosa (50%), followed by platelet-rich fibrin-leukocyte (L-PRF) (25%). The average follow-up was 16.4 weeks, achieving surgical success in 65% of cases. Multivariate analysis was performed without significant differences between demographic characteristics, techniques used, and surgical outcomes.

 Conclusion: Multiple surgeries have been described, with highly variable success rates. In our center, AEAf was the most commonly used. Other flaps were also utilized, making it difficult to demonstrate superiority of one over the other due to the design of our study, as well as with the use of various grafts, including L-PRF.