A Retrospective Study on the Reconstruction of Nasal Septal Mucosal Defects after Asian Rhinoplasty

Overview

The septum is covered on both sides by mucosa, the moist lining. When that lining is lost after rhinoplasty, cartilage can be left exposed and the repair is difficult. The authors retrospectively reviewed 13 such cases treated between January 2016 and October 2021, choosing the repair method according to the size, position and severity of the defect and how much cartilage was exposed.

Sections of note

• Design: retrospective case review, 13 patients. Level of evidence IV.
• Repair method was selected case by case based on defect size, location, severity and extent of cartilage exposure.
• Outcomes assessed with a patient questionnaire using a visual analog scale and the NOSE blockage scale.
• Average postoperative follow up: 10.15 months.
• All patients were treated successfully, with no flap failure and no narrowing of the nasal valve.
• All patients were satisfied with the reconstruction, though no numerical scores are given in the abstract.
• The authors single out the retrograde-flow superior labial artery mucosal flap as secure and effective, particularly where cartilage is exposed.

What it means for a patient

• A hole in the septal lining after rhinoplasty is an uncommon but serious complication, and left untreated it can progress to a full septal perforation.
• The repair uses lining moved from nearby, kept attached to its blood supply, rather than a graft or implant.
• All 13 healed, but 13 patients cannot establish a success rate for a technique.
• Limits: retrospective, single group, no comparison of methods, average follow up under a year, and satisfaction reported without numbers.

Why this paper matters

Lining injury is one of the complications rhinoplasty surgeons most want to avoid, and published guidance on repairing it is sparse. Matching a specific flap to the defect gives a decision framework. Whether the repairs hold beyond a year, and how often perforation still develops, is not shown.

Terms

• Nasal mucosa: the moist lining covering the inside of the nose.
• Septal mucosal defect: a hole in that lining over the septum.
• Flap: tissue moved to a new position while staying attached to its blood supply.
• Superior labial artery: a branch of the facial artery supplying the upper lip and nasal base.
• Nasal valve stenosis: narrowing of the nasal airway from scarring or contraction.
• NOSE scale: a questionnaire measuring nasal blockage, where higher means worse.