Inferior Turbinate Flap for Closure of Septal Perforations

EDITORIAL COMMENT

Septal perforations are most difficult to close. The use of buccal mucosa or skin usually gives unsatisfactory results; consequently, the use of similar types of mucosa from the inferior turbinate is most advantageous. The limiting factor, as the authors indicate, is that two procedures may be required and there is only a small amount of tissue that can be mobilized safely.

The inferior turbinate flap, although not always successful, can be used to repair symptomatic septal perforations; specific symptoms such as epistaxis, whistling, and frontal headache appear to improve, even after partial closure.

INDICATIONS

Several methods for surgical closure of perforations of the nasal septum have been proposed (1, 2, 3, 4, 5, 6). The inferior turbinate flap was introduced in 1980 by Masing and colleagues (1). Their concept was based on the assumption that symptoms such as crusting, obstruction, bleeding, and whistling are caused by the desiccating effects of the inspiratory airflow on the posterior rim of the perforation. Consequently, this technique aims at protection of the posterior rim from inspiratory airflow, not necessarily at complete closure of the perforation itself.

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