Simultaneous Rhinoplasty and Septal Perforation Repair Using the Bone-Cartilaginous Unit

Sazgar AA, Sazgar MA, Zarringhalam MA, Sazgar AK.

What this paper says

In 31 patients having rhinoplasty and septal perforation repair together, a composite bone-and-cartilage septal graft as scaffold achieved complete closure in 83.8% and large improvements in SCHNOS obstruction (31.93 points) and cosmesis (44.19 points) scores.

Overview

Perforation repairs use lining flaps, but a scaffold helps position them and supports new lining growth. The Iranian authors used a bone/cartilage (BC) unit from the patient's own septum to cover cartilaginous perforations in patients having rhinoplasty at the same time, between 2019 and 2023, with at least one year of follow-up.

Sections of note

31 patients (22 women, 9 men); mean age 34.80 (SD 10.31), range 19-59.
9 had prior septoplasty and 4 prior septorhinoplasty.
Perforation size 6-27 mm, mean 14.1 mm.
Complete closure in 26 (83.8%); incomplete in 3; re-perforation in 2.
SCHNOS-O fell by 31.93 (SD 26.47); SCHNOS-C by 44.19 (SD 25.37).

What it means for a patient

A hole in the septum and a rhinoplasty can be dealt with in one operation with a good closure rate.
About 1 in 6 did not achieve full closure; perforation repair is never guaranteed.
Breathing and appearance scores both improved substantially.

Why this paper matters

It supports combining perforation repair with rhinoplasty using the septum's own bone-cartilage composite as scaffold. Limits: 31 patients, no comparison, single centre.

Terms

Septal perforation: a hole through the nasal septum.
Bone-cartilaginous (BC) unit: a piece of septum harvested with bone and cartilage together.
Scaffold: a support placed under lining flaps to hold them and encourage healing.
Re-perforation: a hole reopening after repair.
SCHNOS: a validated nasal questionnaire with obstruction and cosmesis subscales.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“Various techniques are employed for septal perforation repair but success rates still vary. Numerous mucosal flaps are used for septal perforation closure; however, a scaffold is essential for proper positioning and enhanced mucosal growth. Objectives: The aim of this study was to assess the effectiveness of utilizing…”

Excerpt; the full abstract is on PubMed.