Septal perforation repair can be challenging, especially for larger perforations without cartilage support. The document reviews techniques for endoscopically repairing septal perforations using flaps based on the size, location, available cartilage, and other patient factors. Completely closing the perforation without tightness and preserving blood flow are the most important factors for avoiding recurrence, and changing the flap if needed can help ensure a successful repair and prevent failure.

1. How to avoid recurrence of Septal perforation repair
Background
Septal perforation repairisconsideredone of challengesinthe rhinologyspeciallyif there isnocartilage
supportand the perforationisbiggerthan1.5 cm
Method
Reviewingseriesof 10 cases of variable sizesof septal perforationswhichdone endoscopicallybymany
techniquesaccordingthe place,size,cartilage availability,patientcompliance,andotheraccompanying
diseases.
Result
There are manytechniquestorepairthe septal perforation (rotationflap,flipflap,inferiormetal flap
and others),andyoucan choose any one of these techniquesaccordingtothe situation.Butclosingthe
perforationcompletely(byexcellentplanninghow toharvestthe flap),avoidingany tightness,and
preservingthe vasculature are consideredthe mostimportantfactorstoavoidthe failure.
Discussion
Endoscopicrepairof septal perforationisvery successful (about100%) if we avoidedthe failurefactors
as avoidance of failure factorsisveryparamountevenitrequireschangingthe wholeflaptotake
anotherone.