Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0037-1604425
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Temporoparietal Fascia Free Flap for Nasoseptal Perforation Repair

Samuel Helman1, Sameep Kadakia1, Ashley Guthrie1, Moustafa Mourad2, Grigoriy Mashkevich1
  • 1Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, New York, New York
  • 2Department of Otolaryngology, Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas
Further Information

Publication History

01 February 2017

02 April 2017

Publication Date:
25 August 2017 (eFirst)


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.