The Tricellufuse Technique for Closing Nasal Septal Perforations

Objective: Nasal septal perforation (NSP) is a structural anomaly that affects the mucosa, cartilage, and bone of the nasal septum, often stemming from septoplasty as the primary cause. Spontaneous healing of a perforated septum is rare, and typically the healing process is observed until it is determined that the condition is stable and no longer deteriorating, at which point surgical intervention is considered. Numerous surgical techniques have been proposed for NSP repair. This study introduces a novel approach incorporating a fascia lata graft with fat tissue and diced septal cartilage to reconstruct medium-sized NSP. Methods: The researchers conducted a retrospective analysis involving 22 patients who underwent repair for NSP from January 2021 to January 2023. Grafts were obtained, and the perforation was addressed using an open rhinoplasty technique, followed by the insertion and suturing of the graft. Results: The mean size of the septal perforations was 12 mm horizontally and 13 mm vertically. All patients with NSPs were chosen as medium size (within 0.5-2 cm). The mean follow-up period was 12 months. Complete closure of NSP was achieved in 19 out of 22 patients (86.3%). Among the cases, 15 were male (68%), and the ages ranged from 25 to 45 years with a mean of 35. Eight cases (36%) were smokers. After 12 months postoperatively, closure was not achieved in 3 medium-sized NSPs due to smoking. The analysis revealed that the failure rate in the smoker group was statistically significant (P =.036). Conclusion: The TriCelluFuse technique, combining fascia lata, fat tissue, and diced septal cartilage, is a secure and reliable method for closing NSPs. It has a significant success rate and should be considered a viable option for individuals with NSPs.