Abstract
Concurrently performing septal perforation repair and rhinoplasty is challenging.
Successful management of patients who require or desire these procedures performed
simultaneously can be achieved with appropriate preoperative workup and optimization,
thoughtful surgical planning, masterful execution, and diligent postoperative care.
Consideration of perforation etiology and status of the perforation along with overall
nasal health are the foundation upon which surgery may be planned. Preoperative evaluation
to determine locations of obstruction, aesthetic goals, and feasibility of procedure
is required. Rhinoplasty techniques and perforation closure techniques may share common
maneuvers making concurrent surgery possible. Surgical techniques to achieve perforation
closure often influence rhinoplasty considerations, and vice versa. Care must be taken
to account and possibly even to capitalize on these influences. Perforation closure
techniques that may be readily combined with rhinoplasty include interposition grafting
and intranasal mucosal rotational advancement flaps, which may exert forces upon the
nose with aesthetic or functional consequences. Rhinoplasty techniques targeting any
third of the nose also can impact tension or available mucosa for perforation closure
techniques. Combining these procedures can be very rewarding for the patient and provider
but should be considered responsibly and thoughtfully.
Keywords
rhinoplasty and septal perforation - mucosal flaps - perforation repair - combined
rhinoplasty
