By Dr. Alfonso Santamaría
Septal perforation repair with the Racket on Donut technique has become an innovative and effective tool to address this condition that affects the nasal septum, the structure that separates the right and left nostrils. Septal perforation can cause significant discomfort, such as difficulty breathing, recurrent nosebleeds, and loss of smell. However, thanks to advances in medicine and innovative surgical techniques, such as the aforementioned technique, patients now have effective options to treat this condition.
El Dr. Alfonso Santamaría, medical specialist in rhinology at the Ramón y Cajal University Hospital in Madrid (Spain), has shared his experience in Surgical training app SURGSCHOOL, where he details step by step how to carry out this surgery.
What is the “Racket on Donut” technique?
The “Racket on Donut” technique is a surgical approach used to repair septal perforations. It is based on the creation of tissue flaps that are used to effectively close the perforation. This approach is called "Racket" because of the shape of the greater palatine artery flap, which resembles a tennis player's racket, and "Donut" because of the invertitechis flap used to reinforce the closure.
Step by step procedure:
- Drilling evaluation: The surgeon identifies the location and size of the septal perforation using specialized instruments and tools.
- Site preparation: Local anesthesia is infiltrated to reduce bleeding and facilitate dissection of the tissue flaps.
- Structure identification: Important structures, such as the anterior nasal spine and the greater palatine artery, are identified to avoid damage during surgery.
- Flap creation: Precise incisions are made to create flaps of tissue that will be used to close the septal perforation. This includes the greater palatine artery flap and the invertitechis flap.
- Dissection and placement: The flaps are dissected and carefully positioned to completely cover the septal perforation.
- Closing: End-to-end sutures are performed to secure the flaps in place and effectively close the perforation.
- Placement of Doyle cannulas: Silicone cannulas are placed to facilitate healing and protect the operated area.
Results and recovery:
After surgery, patients are expected to experience significant improvement in symptoms associated with septal perforation. Complete healing may take several weeks, during which silicone cannulas may be used to aid the healing process.
