Closure of nasal septal perforation with a cutaneous flap and a perichondrocutaneous graft.

A cutaneous flap from the cheek and a perichondrocutaneous free graft is used for closing a perforation of the nasal septum. The cutaneous flap is rotated to set into the defect covering one side of the perforation while the other side is covered with a free perichondrocutaneous graft, nutrified by vascular proliferation from the cutaneous flap. The anterior side of the auricular concha is used as donor site for the composite perichondrocutaneous graft. The cutaneous flap is divided after about four weeks. Twenty-eight patients have been operated on with this technique; 27 had a complete closure after an observation time of four to eight years. A biopsy three months after the operation showed that the perichondrium generated cartilage as supporting tissue. The technique was modified as using a labiobuccal mucosal flap showed unfavourable results.