Case Report – Two-staged nasal septal perforation repair with a conchal cartilage graft as a preformed radial forearm flap

Background The repair of nasal septal perforation is considered as one of the most difficult surgeries in otorhinolaryngology. Especially larger perforations can only be repaired in multiple steps due to unfavorable tissue characteristics. This case report from our ENT clinic presents a new and unique method of two-staged septal perforation repair by using a preformed radial forearm flap with a conchal cartilage graft.

Case A 32-year old and a 48-year-old patient presented to our ENT clinic and reported both about an existing nasal septal perforation with severe nasal obstruction and nasal dryness with crusting for many years. On clinical examination both patients showed a third-degree septal perforation. Due to the size of the defect we decided on a two-staged approach, which was executed almost identical for both patients. In the first step a conchal cartilage graft matching the size of the nasal septal defect was transplanted above the left volar forearm fascia, approximately 2cm lateral to the radial artery. By the preformation of the flap neovascularization is induced over the course of time, which enables the final nasal septal correction in the second step (about 6 to 10 weeks later) with an open incision and microvascular connection of the graft to the facial artery and vein.

Conclusion Two-staged nasal septal perforation repair with a preformed radial forearm flap is a new, unique method, which is suited for the closure of a subtotal nasal septal perforation.

Poster-PDF A-1540.pdf

Conflict of interest

Der Erstautor gibt keinen Interessenskonflikt an.

Publication History

Article published online:
13 May 2021