Three-layer repair of nasoseptal defects.

Abstract

This article demonstrates technique and results of a 3-layer repair of nasoseptal defects using bilateral bipedicled advancement flaps and an autogenous cartilage graft. After an extensive bilateral elevation of the mucosa from the entire septum, the nasal dome and the nasal floor bipedicled advancement flaps are created. The mucosal defects are sutured and an autogenous cartilage graft is interposed between the sutured mucosal flaps. Until now this technique has been applied in 403 patients. The success rate (complete closure) was 92.5%. Thirty-four patients redeveloped defects; 28 were <5 mm and did not cause complaints. Results show that the described technique is a most reliable method with the following advantages: 1 stage procedure, no visible scars, high success rate, and low complication rate. In case of an incomplete closure, the redeveloped defect will generally be considerably smaller than the original one and asymptomatic.