Surgical closure of nasoseptal perforations: predictive factors for success

Objectives: This study investigated the predictive factors for successful closure of a nasoseptal perforation (NSP) using bilateral advancement flaps via an external approach. Methodology: A retrospective observational study was performed on the files of patients who underwent surgical closure of an NSP between 1999 and 2015 at the University Hospitals of Leuven, a single tertiary centre. Sex, underlying aetiology, characteristics of the perforation (location, size, and surgical technique used), and the pre- and postoperative symptoms were recorded and analyzed. Results: The initial size of the NSP turned out to be the only significant factor. Complete closure of the NSP was achieved in 67% of the whole cohort and in 82%, 67%, and 15% of the sub-cohorts with small (< 1 cm), medium (1 – 1.9 cm), and large-sized (≥ 2 cm) NSPs, respectively. In case of a residual perforation, 44% of the patients had no postoperative symptoms. Conclusions: A high surgical success rate can be obtained by using bilateral advancement flaps via an external approach to close small to medium-sized (< 2 cm) NSPs, but alternative techniques should be considered to repair large NSPs (≥ 2cm). Good postoperative function could be achieved, even with incomplete closure.