Surgical management of the septal perforation.

Initial management of a septal perforation involves medical intervention, but there are several surgical options available. Deciding to proceed with a surgical repair is dependent on the etiology of the defect, how the symptoms impact the patient, the extent of damage or impending destruction to the nasal support, and the absence of any active disease process. The literature describes several methods for septal perforation repair; each has its technical challenges because of the tenuous nature of the tissues and limited surgical exposure of the area. This article reviews the diagnostic work-up of septal perforations, the medical management, and the surgical treatment options, with emphasis placed on the open rhinoplasty approach.