KeypointsDespite the variety of surgical techniques available to close big symptomatic septum perforations, closure rates of 30% to 70% indicate the difficulty of obtaining a good end result.The double meat hook technique is a new endoscopically assisted technique that delivers excellent visualisation and control of mucosal flap elevation, extension and suturing.Mucosa from the nasal floor, lateral nasal wall and inferior turbinate bone are valuable donor site extensions.There is no need for additional incisions into the nasal septal mucosa to perform a tension‐free closure. Preservation of the structural integrity and blood supply of the mucosal flaps possibly contributes to a high closure rate and delivers a physiological result.INTRODUCTIONA nasal septum perforation is a defect in three distinct contiguous layers, composed of both right and left septal mucoperichondrial flaps and the intermediate cartilage. The interruption of the structural integrity of the septum disrupts lamellar nasal airflow. Subsequently, patients can present with a spectrum of complaints such as nasal obstruction, crusting, recurrent epistaxis, Saddle nose deformities and whistling.A septum perforation never closes spontaneously. Management of symptomatic patients initially has to be conservative with regular nasal irrigation and emollients. A silicone septal obturator is an alternative conservative option but this non‐physiological device can
Clinical Otolaryngology – Wiley
Published: Jan 1, 2018
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