[Treatment by enlargement of septal perforations]

Abstract

Objective: Assessment of surgical posterior enlargement for septal perforation.

Material: Ten patients included had a symptomatic perforation in area 2 and/or 3 of Cottle. The size of the perforations was superior at 10 mm.

Method: This is a retrospective study. The surgical procedure has consisted of an initial corection of anterior septal deviation, nasal deviation and supra-lobular depression. Afterwards, perforations were extended towards the back by respecting the choanal arch. Nasal obstruction, headache, epistaxis, crusting and nasal profil were assessed in preoperative and post surgical period at 2 months and at the time of a sent questionnaire. A visual analogue scale for nasal obstruction and headache was used.

Results: The patient's mean age was 53.9 years. The mean follow-up period was 16 months. The average hospital stay was 24 hours. In first step, two supra-lobular depresion and one nasal deviation were corected. The mean score of nasal obstruction was 7.6. All patient's were free of this symptom after surgery (10/10) (p < 0.00016). The mean score of headache was 7.8 and only five of the six patients were free of symptom (p < 0.01). Crusting and epistaxis were diseappared in seven of the height patients. The rate of success for the different symptom were 100% for nasal obstruction, 83.3% for headache and 87.5% for crusting and epistaxis.

Conclusion: The surgical posterior enlargement for septal perforation is an effective procedure, reliable, simple, with very low morbidity.