Aim:This study isolates septal perforations due to nasal surgery for clinical analysis and their effect on bilateral mucosal flap repair.Methods:This is a retrospective review of a single surgeon's 20-year experience with endonasal perforation repair utilizing bilateral mucosal advancement flaps supported with an autologous tissue interposition graft.Patients with a minimum of 4-month postoperative follow-up were included in the study.Comparative analyses of repair failure rates and perforation size of failures between surgical and non-surgical etiologies were performed.Results:Three hundred ninety-two patients met the criteria for inclusion in the study.The incidence of perforation and prior septal surgery was 40.6%.Overall repair closure in patients with a minimum of 4 months follow-up was 94.8%.Failures were noted in 5.7%of surgical and 4.7%of non-surgical perforation etiologies(P = 0.816).Mean differences in perforation length and height in failed repairs between non-surgical and surgical etiologies(19.4 vs.13.7 and 15.5 vs.9.3 mm,respectively)were significant(P = 0.048 length,P = 0.006 height).Conclusion:Post-surgical nasal septal perforations can be repaired with a low rate of failure.However,this study found that the size of perforations in failed repairs was significantly smaller in patients with a history of septal surgery,suggesting that prior septal surgery increases the technical difficulty of a bilateral flap perforation repair.
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