Intraoperative Treatments

Nasal septal perforation repair demands precision and expertise to ensure successful outcomes. In this article, we delve into the sophisticated intraoperative techniques employed by Mr. Hassan Elhassan for addressing nasal septal perforations. The meticulous process involves several key steps aimed at confirming, measuring, limiting, and effectively repairing the perforation. The Interoperative process includes the following steps: 

1. Confirmation and Measurement

The initial step involves confirming the presence of a septal perforation and measuring its dimensions on the morning of the operation using an endoscope. The flap’s posterior limitation is carefully identified by the junction of the hard and soft palate. Additional incisions are strategically made to facilitate the repair process.

Image (1) Septal Measurement | Author: OpenStax College | Image courtesy: Wikipedia.

2. Flap Limitation

The intraoperative flap is precisely limited posteriorly by the junction of the hard and soft palate, ensuring a targeted approach to the repair. This step is critical in preparing the groundwork for subsequent incisions and rotations.

Image (2) | Author: OpenStax College | Image courtesy: Wikipedia.

3. Incision and Rotation

Extending the incision laterally under the inferior turbinate and creating a vertical incision posteriorly to the septal projection of the axilla of the middle turbinate allows for the creation of a large pedicled flap. This flap is then expertly rotated to cover the perforation, eliminating the need for additional skin or cartilage grafts.

Image (3) | Author: OpenStax College | Image courtesy: Wikipedia.

4. Postoperative Results

Success is evident in postoperative views, showcasing the closure of the perforation and complete coverage of the nasal floor with nasal epithelium at different intervals. Nasendoscopic findings at 3 weeks and 14 weeks postoperatively illustrate the effectiveness of the repair technique.

Image (4) | Author: OpenStax College | Image courtesy: Wikipedia.


Patients undergoing Mr. Hassan’s Method for repairing septal perforations benefit from a procedure that eliminates the need for skin grafts or cartilage grafts, preserving the integrity of nasal turbinate’s. Preoperative and postoperative examinations, with a 4-week interval between the two, ensure a comprehensive assessment of the procedure’s success and the patient’s overall well-being. Mr. Hassan’s approach stands as a testament to innovative and effective septal perforation repair.

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