DOI: 10.1055/s-0037-1604425
Temporoparietal Fascia Free Flap for Nasoseptal Perforation Repair
Publication History
01 February 2017
02 April 2017
Publication Date:
25 August 2017 (eFirst)

Abstract
Nasoseptal perforations can be a challenging defect for the reconstructive surgeon, with repair limited by the surrounding tissue availability and the defect size. In patients with a history of cocaine use, often the integrity of surrounding vasculature is questionable and large defects may not be well suited for local reconstruction. In the otolaryngology literature, several reconstructive options using local tissue and synthetic materials have been described, but there have been no reports of microvascular free flaps utilized in this regard. We present a unique case of a 37-year-old woman with a 3.0 cm × 3.5 cm nasoseptal perforation secondary to cocaine use successfully reconstructed with a temporoparietal fascia free flap anastomosed to the facial artery and vein. Postoperatively, the patient had a well-healed septal defect from the free flap reconstruction This new technique shows promise as a feasible option for patients with large defects and for those with limited local reconstructive options. The ease of harvest and low donor-site morbidity make the temporoparietal fascia flap a suitable option for repair of complex nasoseptal defects.
References
- 1 Moon IJ, Kim SW, Han DH. , et al. Predictive factors for the outcome of nasal septal perforation repair. Auris Nasus Larynx 2011; 38 (01) 52-57
- 2 Foda HM, Magdy EA. Combining rhinoplasty with septal perforation repair. Facial Plast Surg 2006; 22 (04) 281-288
- 3 Bank J, Beederman M, Naclerio RM, Gottlieb LJ. Prelaminated fascia lata free flap for large nasal septal defect reconstruction. J Plast Reconstr Aesthet Surg 2014; 67 (10) 1440-1443
- 4 Kong DK, Schutt CA, Mehra S. Temporoparietal fascia flap “sandwich” technique for repair of near-total traumatic auricle avulsion. Laryngoscope 2016; 126 (04) 826-828
- 5 Kim SW, Rhee CS. Nasal septal perforation repair: predictive factors and systematic review of the literature. Curr Opin Otolaryngol Head Neck Surg 2012; 20 (01) 58-65
- 6 Ceylan A, Ileri F, Celenk F, Yilmaz M, Uslu S. Upper lateral cartilage inner mucoperichondrial flap technique for the repair of nasal septal perforation. ORL J Otorhinolaryngol Relat Spec 2007; 69 (04) 245-250
- 7 Re M, Paolucci L, Romeo R, Mallardi V. Surgical treatment of nasal septal perforations. Our experience. Acta Otorhinolaryngol Ital 2006; 26 (02) 102-109
- 8 Heller JB, Gabbay JS, Trussler A, Heller MM, Bradley JP. Repair of large nasal septal perforations using facial artery musculomucosal (FAMM) flap. Ann Plast Surg 2005; 55 (05) 456-459
- 9 Paloma V, Samper A, Cervera-Paz FJ. Surgical technique for reconstruction of the nasal septum: the pericranial flap. Head Neck 2000; 22 (01) 90-94
- 10 Mobley SR, Boyd JB, Astor FC. Repair of a large septal perforation with a radial forearm free flap: brief report of a case. Ear Nose Throat J 2001; 80 (08) 512
- 11 Romo III T, Foster CA, Korovin GS. , et al. Repair of nasal septal perforation utilizing the midface degloving technique. Arch Otolarygol Head Neck Surg 1988; 114: 739