Septal perforation repair.

Nasal septal perforations present a distinct challenge to the otolaryngologist-head and neck surgeon, and a problem to the patient. The techniques for repairing septal perforations that have the best physiologic result, the highest success rate, and the best long-term patient acceptance and comfort, require the use of bilateral intranasal mucosal advancement flaps with the interposition of a connective tissue graft. The presenting symptoms and findings, the history and physical examination, the causes of septal perforations, helpful hints for prevention, and surgical and nonsurgical treatment options and outcomes are discussed in this article.