Reconstruction of the defects of the nose: strategies from simple to complex 

Nasal septal perforation is a common issue that can be caused by primary or secondary factors. In cases of large perforations, laminar airflow is disrupted by turbulence, leading to a feeling of nasal congestion. Extensive perforations can also result in loss of dorsal support and a saddle nose deformity. Septoplasty, with or without rhinoplasty, is the primary cause of septal perforation. Repairing large septal perforations has proven to be a challenge for many facial plastic surgeons. The key to success lies in creating large vascularized nasal flaps to allow for a relaxed closure without any tension.

Dear members of the scientific committee,

i hope this message finds you well. My name is melis demirag evman, and i am a specialist in otolaryngology at kartal dr.Lutfi kirdar city hospital, turkey. I would like to express my interest in contributing to the upcoming IFOSTANBUL 2026 by delivering a talk on endoscopic septal perforation repair techniques.

in my clinical practice and research, i have focused on the refinement of endoscopic surgical techniques for septal perforation repair, emphasizing minimally invasive approaches, mucosal flap design, and postoperative management strategies. My video presentation would summarize various surgical techniques of endoscopic septal perforation repair.

given the continuing evolution of transnasal endoscopic approaches and their importance in functional nasal surgery, i believe this topic would provide valuable practical and academic insights for especially attending ENT surgeons.

with kind regards,

melis demirag evman m.D., FEBORL-HNS

[email protected]

+90506 587 79 09

Objective:

to introduce and evaluate the effectiveness of a novel endoscopic tension-free locking suture technique for repairing nasal septal perforations, aimed at achieving high closure rates while minimising mucosal tension and surgical morbidity.

The centripetal endoscopic sinus surgery is an ethmoidectomy technique described and invented by prof. Alexandre Felippu, in Brazil, in 1984. This technique is widely spreaded troughout the world since then as an excellent approach to the ethmoid sinus using very little material. Learn to perform a safe ethmoidectomy with excellent results watching real cases with pre and pos operative documentation.

Aims: this study examined the frequency of comorbidities in patients with respiratory epithelial adenomatoid hamartoma (REAH) and determined whether comorbidity affects the clinical characteristics of REAH.

methods: a retrospective cohort study included patients with REAH who had been treated and followed up over 15 years. Clinical parameters included the side of the nasal cavity, localization and size of the lesion, duration of symptoms, and associated chronic inflammation.

results: twenty (n = 20) patients with REAH were included. We found an association of REAH with chronic sinonasal inflammatory disorders in 70% of cases: in 30% with perennial allergic rhinitis (PAR), in 25% with chronic rhinosinusitis with nasal polyps (crswnp), and in 15% of cases with aspirin-exacerbated respiratory disease (AERD). In 87.5% of cases of bilateral REAH, the lesion was associated with inflammatory nasal polyps, in 80% of patients with crswnp as a comorbidity, and in 100% of patients when it was AERD. Symptoms were longer in REAH patients with associated sinonasal inflammation (p ˂ 0.038). We had a far greater average volume of REAH in patients with AERD than in cases with PAR, and crswnp (p ˂ 0.001; p ˂ .001, respectively). A positive correlation was found between the duration of symptoms and the lesion volume (r = 0.700; p = 0.001).

conclusion: a high degree of association between REAH and chronic sinonasal inflammation was found. The results also suggest that inflammation in AERD is the strongest provoking factor for the growth of REAH. A direct correlation was observed between the duration of nasal symptoms and the lesion size.