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Bilateral Versus Unilateral Repair of Nasal Septal Perforation: A Two‐Center Retrospective Study

Bilateral Versus Unilateral Repair of Nasal Septal Perforation: A Two‐Center Retrospective Study INTRODUCTIONSurgical repair of nasal septal perforation (NSP) has recently become one of the fastest growing areas in rhinology. This is evidenced by the increasing number of publications and novel surgical techniques.1–3The use of an endoscope and the use of vascularized flaps have changed surgeons' views somewhat. A clear trend toward unilateral perforation closure has emerged.4,5In general, the authors explain that the advantages of this approach include the fact that the unilateral layer flap is thinner than other types of bulky septal reconstruction, which is prone to possible nasal obstruction; it provides minimal donor site morbidity and preservation of the mucosa of the contralateral nasal fossa; it requires a one‐stage procedure and a short hospital stay.5However, according to other articles, bilateral closure with two mucosal flaps is of great importance, the advantage of which is presumably attributed to increased vascularization. Cases of repair with bilateral mucosal coverage with or without interpositioned cartilaginous grafts had a significantly higher rate of surgical success than cases of unilateral coverage alone.6–8In addition, unilateral perforation closure leaves the uncovered side of the septum to heal by secondary intention, which delays healing time and may result in scar tissue formation, contributing to persistent dryness and crusting.2,9The http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png The Laryngoscope Wiley

Bilateral Versus Unilateral Repair of Nasal Septal Perforation: A Two‐Center Retrospective Study

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References (16)

Publisher
Wiley
Copyright
© 2025 The American Laryngological, Rhinological and Otological Society, Inc.
ISSN
0023-852X
eISSN
1531-4995
DOI
10.1002/lary.31922
Publisher site
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Abstract

INTRODUCTIONSurgical repair of nasal septal perforation (NSP) has recently become one of the fastest growing areas in rhinology. This is evidenced by the increasing number of publications and novel surgical techniques.1–3The use of an endoscope and the use of vascularized flaps have changed surgeons' views somewhat. A clear trend toward unilateral perforation closure has emerged.4,5In general, the authors explain that the advantages of this approach include the fact that the unilateral layer flap is thinner than other types of bulky septal reconstruction, which is prone to possible nasal obstruction; it provides minimal donor site morbidity and preservation of the mucosa of the contralateral nasal fossa; it requires a one‐stage procedure and a short hospital stay.5However, according to other articles, bilateral closure with two mucosal flaps is of great importance, the advantage of which is presumably attributed to increased vascularization. Cases of repair with bilateral mucosal coverage with or without interpositioned cartilaginous grafts had a significantly higher rate of surgical success than cases of unilateral coverage alone.6–8In addition, unilateral perforation closure leaves the uncovered side of the septum to heal by secondary intention, which delays healing time and may result in scar tissue formation, contributing to persistent dryness and crusting.2,9The

Journal

The Laryngoscope – Wiley

Published: May 1, 2025

Keywords: intranasal surgery; nasal septal perforation; pedicled flap

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