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Enhancing the coverage and rotation of anterior ethmoidal artery flap for septal perforation closure: Insights from a flap design study

Publicat a:Acta Otorrinolaringologica Espanola. 75 (6): 367-372 - 2024-11-17 75(6), DOI: 10.1016/j.otoeng.2024.06.002

Autors: Garaycochea, Octavio; Pineros, Lina; Strahlen, Camilo Rodriguez-Van; Rojas-Lechuga, Maria Jesus; Alobid, Isam

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Background and objectives: The anterior ethmoidal artery flap (AEA) is a pedicle endonasal flap frequently used to repair septal perforations (SP). The posterior incision is the most complex to perform. The primary objective was to determine the minimum height of the posterior incision (PI) of an AEA completely cover an anterior septal perforation. Materials and methods: A cadaveric specimen was sectioned in the sagittal plane and a SP of 1 cm was created anteriorly. The PI of the AEA flap was made progressively at a height of 10, 20, 30, and 40 mm. The complete closure of the SP and the angle of rotation (AR) of the flap were assessed. Results: According to the length of the PI the following results were obtained: PI = 10mm: The SP was covered partially, and the AR was 45o. PI = 20 mm: The SP was fully covered, and the AR was 63o. PI = 30 mm and 40 mm: The SP was fully covered with redundant tissue. This study shows that an anterior ethmoidal artery flap that includes the nasal floor and the inferior meatus mucosa combined with a posterior incision of 20 mm could result in adequate coverage of all margins of an anterior SP up to area 1a of the septum. (c) 2024 Sociedad Espanola de Otorrinolaringolog & imath;a y Cirug& imath;a de Cabeza y Cuello. Published by Elsevier Espana, S.L.U. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

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