CC BY 4.0 · Surg J (N Y) 2021; 07(01): e26-e29
DOI: 10.1055/s-0040-1713418
Original Article

Nasal Septal Perforation Repair with an Inferior Turbinate Flap and Acellular Dermal Matrix

Saeid Mirzai
1   Alabama College of Osteopathic Medicine, Dothan, Alabama
Andrew H. Lee
2   Department of Otolaryngology - Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
John J. Chi
3   Division of Facial Plastic & Reconstructive Surgery, Department of Otolaryngology - Head & Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
› Author Affiliations
Funding No sources of funding to disclose for this study.


Nasal septal perforation is an uncommon disorder that can cause disturbance of nasal physiology. The perforations can vary widely in size, location, and symptomatology. Many different closure techniques have been described in the literature; however, no gold standard has been recognized. The choice of surgical technique usually depends on the characteristics of the perforation and surgeon experience. Due to the goal of perforation repair being restoration of normal nasal physiology, techniques with the best outcomes have been those resurfacing the septum with nasal respiratory mucosa. Here we present our novel surgical method for large (> 2 cm) septal perforation closure using a modification of the inferior turbinate flap repair using a polydioxanone plate and the acellular dermal matrix allograft (Alloderm, Allergan Inc.).

Author Contribution

S. M., A. H. L., and J. J. C. have made substantial contributions to the conception and design, acquisition of data, or analysis and interpretation of data; drafting the article or revising it critically for important intellectual content; final approval of the version to be published; and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.


This paper has not previously been presented.

Publication History

Received: 24 November 2019

Accepted: 06 May 2020

Article published online:
23 February 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (

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  • References

  • 1 Santamaria-Gadea A, Lopez-Chacon M, Langdon C. et al. Modified nasal floor and inferior meatus flap for septal perforation repair. Extension and limits. Rhinology 2018; 56 (04) 386-392
  • 2 Teymoortash A, Hoch S, Eivazi B, Werner JA. Experiences with a new surgical technique for closure of large perforations of the nasal septum in 55 patients. Am J Rhinol Allergy 2011; 25 (03) 193-197
  • 3 Murakami CS, Kriet JD, Ierokomos AP. Nasal reconstruction using the inferior turbinate mucosal flap. Arch Facial Plast Surg 1999; 1 (02) 97-100
  • 4 Delaney SW, Kridel RWH. Contemporary trends in the surgical management of nasal septal perforations: a community survey. Facial Plast Surg 2019; 35 (01) 78-84
  • 5 Friedman M, Ibrahim H, Ramakrishnan V. Inferior turbinate flap for repair of nasal septal perforation. Laryngoscope 2003; 113 (08) 1425-1428