Alternate Sliding Technique for a Nasal Septum Perforation

Abstract

Objective: A critical point for successful surgical closure of the perforation of a nasal septum is the simultaneous achievement of both sufficient blood supply to the closure site and reduced tension of the flaps. We describe a modified surgical technique, the “alternate sliding technique,” to manage this difficulty.

Method: The procedure starts with the elevation of bilateral mucosal flaps under an endoscopic view. A releasing incision is made across the nasal floor on 1 side and across the lateral cartilage on the other side. The flaps are slid up- and downward, respectively. The perforation is then sutured.

Results: Nasal septum perforation was successfully fixed with the first surgery in 6 of the 8 patients. Among them, reperforation was not observed during postoperative follow-up of 3 to 18 months. The symptoms complained of before surgery fully resolved. A patient who had taken corticosteroids for several years and another who had had multiple perforations required the additional closure of a small perforation in our clinic.

Conclusion: Our alternate sliding technique facilitates a better blood supply from the bipedicled attachment. Each suture is lined by a mucosal flap of the other side. These minimize the risk of reperforation. Our technique is applicable for small to medium perforations.