Using fresh frozen cadaveric rib cartilage graft for nasal septal perforation repair.

[INTRODUCTION] The anterior ethmoidal artery (AEA) flap has been demonstrated to be a reliable option for endoscopic repair of symptomatic nasal septal perforations. The use of fresh frozen cadaveric rib cartilage has been described as a safe alternative graft for rhinoplasty procedures.

[GOAL] The aim of this study was to discuss our initial outcomes of use of cadaveric rib cartilage graft in combination with the AEA flap in endoscopic nasal septal perforation repair.

[METHODS] A single institution retrospective case series of all consecutive patients who underwent repair of nasal septal perforation utilizing the AEA flap combined with a cadaveric rib cartilage between December of 2022 to August of 2024 was conducted. Demographics and comorbidities were collected preoperatively. The main outcome of this study was surgical success rate defined as closure of the septal perforation.

[RESULTS] Six patients were included. Four out of six patients had previously failed septal perforation repair, and two patients had a concomitant open septorhinoplasty after raising the AEA flap endoscopically. Overall success rate for complete closure was 100 % with mean follow up of 9.5 months (range of 2-22 months). No major or minor direct postoperative adverse events were encountered.

[CONCLUSION] Initial outcomes of use of the endoscopic AEA flap in combination with a cadaveric rib cartilage graft for closure of a nasal septal perforation are promising. Future studies with larger sample sizes and longer follow up time would be useful to verify these outcomes.