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Combined Septal Perforation Repair with Revision Rhinoplasty Page 01 Page 02 Page 03 Page 04 Page 05 Page 06 Page 07 Page 08 Page 09 Page 10

Although both revision rhinoplasty and septal perforation repair present a unique set of technical difficulties and challenges, both procedures can be attempted simultaneously by the skilled surgeon using the external or open approach. During surgery, the perforation should be repaired first, and the aesthetic revision should follow, accomplishing as much as possible without compromising the perforation repair. Cases in which the perforation is small and in which a dorsal hump can be reduced are the most appropriate for synchronous correction (Fig. 10A and B, and 11A and B)

	Figure 10. A, Preoperative and B, postoperative views of a patient who underwent perforation repair and aesthetic revision.

	Figure 11. A, Preoperative and B, postoperative views of a patient who underwent repair of a septal perforation and reduction of a dorsal hump, which provided more mucosa for closure of the defect.

REFERENCES

1. Fairbanks DNF: Closure of nasal septal perforations. Arch Otolaryngol Head Neck Surg 106:509, 1980
2. Fairbanks DNF, Chen SCA: Closure of large nasal septal perforations. Arch Otolaryngol Head Neck Surg 91:403, 1970
3. Goodman WS, Strelzow VV: The surgical closure of nasoseptal perforations. Laryngoscope 92:121, 1982
4. Kridel RWH: Nasal septal perforation. In Gates G: Current Therapy in Otolaryngology. St. Louis, Mosby Year Book, 1994, pp 361-365
5. Kridel RWH, Appling WD, Wriglit WK: Septal perforation closure utilizing the external septorhinoplasty approach. Arch Otolaryngol Head Neck Surg 112:168, 1986
6. Kridel RWH: The open approach for repair of septal perforation. In Daniel RK (ed): Aesthetic Plastic Surgery: Rhinoplasty. Boston, Little Brown, 1993, p 560
7. Kridel RWH, Konior Rj: Irradiated cartilage grafts in the nose: A preliminary report. Arch Otolaryngol Head Neck Surg 119:24-31, 1993 Address reprint requests to Russell W. H. Kridel, MD, FACS Facial Plastic Surgery Associates 1200 Binz, Suite 1350 Houston, TX 77004

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