Surgery by Dr. Rodolfo Nazar (Clinical Hospital University of Chile)
La septum piercing This represents a frequent reconstructive challenge in otolaryngological surgery, especially when dealing with large defects or those of post-surgical origin. In this case uploaded to the online surgery app SurgSchool’s most emblematic landmarks, the Dr. Rodolfo Nazar, from the Clinical Hospital of the University of Chile, demonstrates an advanced technique of Septal repair using a pedicled flap irrigated by the anterior ethmoidal artery.
Preoperative evaluation and case characteristics
The patient presented with septal perforation of approximately 3 cmThis type of defect, as evidenced by the tomography scan, is often associated with symptoms such as nasal obstruction, crusting, and recurrent epistaxis, in addition to significant aesthetic and functional repercussions.
Surgical technique
The repair begins with the careful carving of flaps from the floor of the nasal cavity, extending laterally below the inferior turbinate. The procedure emphasizes the preservation of the septal mucosa, a key aspect for maintaining tissue viability.
Subsequently, a horizontal incision at the level of the anterior palateconnecting it to another one behind it in the partition. In this way, a flap vascularized by the anterior ethmoidal artery, which is advanced to completely cover the defect.
Are used approximation sutures on the front and top of the perforation, ensuring a watertight seal. Finally, a silicone plate as internal support for three weeks, along with absorbable hemostatic material (Gelfoam).
Results and technical considerations
The procedure allows for stable closure of large septal defects, with good vascularization and minimal morbidity. Irrigation of the anterior ethmoid flap ensures adequate healing and reduces the risk of necrosis or perforation recurrence.
Importance for surgical training
El anterior ethmoidal artery flap It constitutes a highly effective alternative to classic free grafting or bilateral closure techniques. An understanding of its anatomy is fundamental for the otolaryngologists and skull base surgeons interested in advanced septonasal reconstruction.
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