Concomitant Rhinoplasty and Septal Perforation Repair

Overview

Rhinoplasty candidates are often found to have a perforation of the septum, particularly those who have had previous nasal surgery. This article reviews when the two problems can be addressed together and what determines whether a patient is a suitable candidate for the combined operation.

Sections of note

• Surgeons may encounter nasal septal perforations when examining a prospective rhinoplasty candidate.
• Many such patients have had prior septal surgery.
• Small perforations may be asymptomatic.
• Larger perforations may cause nasal obstruction, crusting, bleeding, or external nasal deformities.
• Septal perforation repair and rhinoplasty can be safely and effectively performed simultaneously for the appropriate candidate.
• The article reviews the considerations for determining surgical candidacy for the combined procedure.
• No patient numbers, closure rates, complication rates, or follow-up are reported in the abstract.

What it means for a patient

• A hole in the septum can exist without symptoms and be discovered only at examination.
• When large enough, it causes blockage, crusting and bleeding, and can also collapse the bridge.
• Combining repair with reshaping avoids two separate operations when the patient is suitable.
• This is a review with no data, so it does not report closure success rates or how often the combination is appropriate.

Why this paper matters

Perforations are common in patients seeking revision after earlier septal surgery, and deciding whether to repair and reshape together affects both operations. Setting out candidacy criteria makes that decision explicit. No outcome evidence accompanies the review.

Terms

• Nasal septum: The central wall of cartilage and bone dividing the nose.
• Septal perforation: A hole passing through that wall.
• Concomitant: Performed at the same time.
• Crusting: Dried secretions forming inside the nose, common around a perforation.
• Saddle deformity: A nose whose bridge has collapsed downward, a possible consequence of a large perforation.