Upper lateral cartilage composite flap for closure of complicated septal perforations.

OBJECTIVES/HYPOTHESIS: To present a novel technique for the repair of large complicated nasal septal perforations using an upper lateral cartilage composite flap.

STUDY DESIGN: This is a case series of five patients with large septal perforations seen at an academic tertiary care center, who have failed previous treatment measures and were selected to undergo this novel reconstruction for closure of their defects.

METHODS: Patients were followed clinically to determine the success of the repair. Pre- and postoperative photographic documentation is presented, as well as a description of the surgical technique.

RESULTS: All patients were found to have large septal perforations exceeding 2 × 3 cm in size. The reconstructed septal perforations remained closed for the duration of follow-up. There were no long-term complications related to this technique.

CONCLUSIONS: The composite upper lateral cartilage flap is an effective and reliable means of repairing large and complicated septal defects with respiratory mucosa recruited from the nasal cavity. It may be considered in revision cases prior to entertaining regional extranasal flaps or the use of septal buttons.

LEVEL OF EVIDENCE: 4. Laryngoscope, 127:1767-1771, 2017.