Icon Legend

This session is not in your schedule.

This session is in your schedule. Click again to remove it.

Favorite

Scientific Oral Presentations

Facial Plastic and Reconstructive Surgery

Session: Scientific Oral Presentation 2 - Facial Plastics and Reconstructive Surgery

Outcomes of Surgical Repair for Large Nasal Septal Perforations: A Systematic Review and Meta-Analysis

Monday, October 13, 2025

9:30 AM - 9:36 AM EDT

Location: 137

Disclosure(s):

Matthew HZ Cheung, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Michelle S. Hwang, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Outcomes across different surgical approaches for management of large nasal septal perforations (>2cm) remain unclear and fragmented across literature. This SRMA aims to analyze existing literature on surgical interventions for large NSP and compare success outcomes across different approaches.

Methods: A systematic review (PubMed, Scopus, CINAHL) and meta-analysis was performed on studies employing surgical repair of large nasal septal perforation (>2cm or categorized as "large nasal septal perforation"). Study outcomes included closure or reperforation outcome as primary measures of success outcomes. Meta-analyses of continuous measures and proportions and comparison of weighted proportion were performed

Results: A total of thirty-nine studies involving 929 patients were treated with surgical intervention for nasal septal perforation. Of the 929 patients, 374 patients had large nasal septal perforations (NSP) and were included in the analysis. The mean age of the cohort was 36.7 years with a mean follow-up period of 13.2 months. 62.9% of the cohort were male. Across all studies, size of perforations was measured in two ways: anterior-posterior length and superior-inferior width, or overall diameter. In our analysis average length was 24.6 cm, average width was 22mm and average overall diameter was 26mm. Meta-analysis identified four primary etiologies for large NSP: trauma, drug-use, iatrogenic and idiopathic cases. The overall success rate of surgical repair for large NSP was 82.3% with a reperforation rate of 25.9%. Symptoms resolved in 87.2% of the cohort. Surgical approaches were categorized as mucosal advancements (21.0%), interpositional grafts (29.8%), graft-flap combinations (22.2%), and other techniques (12.3%), with success rates of 80.1%, 82.8%, 71.6%, and 89.9%, respectively

Conclusions: This meta-analysis demonstrated a high overall successful rate of surgical repairs for large NSP (82.3%), with minimal differences in outcome among the different approaches. Therefore, the choice of surgical method may be guided by patient specific factors and surgeon preference.

Presenting Author(s)

Matthew HZ Cheung, BS

Medical Student
Medical University of South Carolina
BROOKLYN, NY, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Cory Hyun-su Kim, BS

Research Fellow
Medical University of South Carolina (MUSC)
Charleston, South Carolina, United States

Disclosure information not submitted.
SN

Shaun A. Nguyen, MD

Professor and Director of Clinical Research
Medical Univ of South Carolina Dept of OTO
CHarleston, SC, United States

Disclosure information not submitted.
Michaela F. Close, MD

Resident Physician
Medical University of South Carolina
Charleston, SC, United States

Disclosure information not submitted.
Vusala Snyder, MD, MS

Resident Physician
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania, United States

Disclosure information not submitted.

Senior Author(s)

Michelle S. Hwang, MD

Assistant Professor
Medical University of South Carolina
Charleston, SC, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.