Endoscopic unilateral anterior ethmoid artery flap with or without cartilage graft for nasal septal perforation repair.

UNLABELLED: The septal perforation is a challenging condition that faces the otolaryngologist. The aim of our work was to evaluate this endoscopic repair of this septal perforation using a unilateral anterior ethmoid artery flap with or without a cartilage graft.

PATIENTS AND

METHODS

The authors conducted a retrospective cohort study between June 2020 and June 2022. Our study included all adult patients with septal perforation due to trauma (operative and self-induced) lasting for more than one year. Patients underwent an endoscopic repair of a perforation and a questionnaire regarding subjective quality of life was completed at 3 months postoperatively.

RESULTS

A total of 18 patients were included in our study. The main symptoms were crusting (100%), bleeding (38.85%), whistling (16.6%), anosmia (16.6), and nasal obstruction sensation (11%). The mean perforation size was 13.6 mm, ranging between 4 mm and 28 mm. Number of years with the perforation (ranged between 2 and 16 years) with a mean of 4.876±1.645 years and a mode of 2 years. All cases were repaired using an endoscopic unilateral anterior ethmoid artery flap with or without cartilage.There were no intraoperative complications but postoperatively, these included pain, ranging between a score of 2 and 8 on the pain score chart, (the mean score was five and mode was four, appeared in six patients), which was treated with over-the-counter painkillers. In addition, there was one patient (5%) with a residual small perforation (2 mm). All patients were happy to fill out postoperative patient satisfaction questionnaires after 3 months. The mean was 21.8889 ±1.655 points and the mode, 25 points (highest possible score), appeared four times. The lowest scoring questionnaire summated to 15 points.

CONCLUSIONS

The endoscopic unilateral anterior ethmoid artery nasal flap with or without cartilage graft has proven to be a reliable and a valuable graft that, with proper planning, can provide excellent results with minimal morbidity for nasal septal perforation repair.