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Nasoseptal Perforation: from Etiology to Treatment

Current Allergy and Asthma Reports volume 18, Article number: 5 (2018) Cite this article

Abstract

Purpose of Review

Nasal septum perforation (NSP) is a communication between the two nasal cavities. This review contributes to the better knowledge of NSP causes, diagnosis, and treatment.

Recent Findings

NSP prevalence is about 1%. Clinical presentation may range from absence of symptoms to the presence of bothersome sinonasal symptoms. NSP is more frequently caused by trauma or post-surgery, inflammatory diseases, and abuse substances. Conservative management (nasal irrigation, topical use of antibiotic or lubricant ointments, or placement of prosthesis) is considered the first-line treatment. Symptomatic NSP not improving with local therapies usually requires surgical approach. Selection of the technique for the endoscopic septal repair depends on perforation characteristics and surgeon experience.

Summary

When NSP is diagnosed, its cause has to be promptly determined. Most of them can be controlled with conservative measures. Surgical/endoscopic approaches are usually needed in refractory cases, and new repair techniques have to be considered.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Most SP, Rudy SF. Septoplasty basic and advanced techniques. Facial Plast Surg Clin North Am. 2017;25(2):161–9. https://doi.org/10.1016/j.fsc.2016.12.002.

    Article  PubMed  Google Scholar 

  2. • Chang DT, Irace AL, Kawai K, Rogers-Vizena CR, Nuss R, Adil EA. Nasal septal perforation in children: presentation, etiology, and management. Int J Pediatr Otorhinolaryngol. 2017;92:176–80. Reports about NSPs in the pediatric population are limited; this is a retrospective chart review performed on 27 pediatric patients diagnosed with nasal septal perforations from 1998 to 2015. https://doi.org/10.1016/j.ijporl.2016.12.003.

    Article  PubMed  Google Scholar 

  3. • Gold M, Boyack I, Caputo N, Pearlman A. Imaging prevalence of nasal septal perforation in an urban population. Clin Imaging. 2017;43:80–2. The prevalence of NSP on facial bone CT scan in an urban hospital setting in New York, USA. They reviewed 3708 CT scans and found a prevalence of NSP of 2.05% (more than double of that previously reported). The most common risk factor was cocaine abuse. https://doi.org/10.1016/j.clinimag.2017.02.002.

    Article  PubMed  Google Scholar 

  4. Oberg D, Akerlund A, Johansson L, Bende M. Prevalence of nasal septal perforation: the Skovde population-based study. Rhinology. 2003;41(2):72–5.

    PubMed  Google Scholar 

  5. Sardana K, Goel K. Nasal septal ulceration. Clin Dermatol. 2014;32(6):817–26. https://doi.org/10.1016/j.clindermatol.2014.02.022.

    Article  PubMed  Google Scholar 

  6. Lanier B, Kai G, Marple B, Wall GM. Pathophysiology and progression of nasal septal perforation. Ann Allergy Asthma Immunol. 2007;99(6):473–9; quiz 480-1, 521. https://doi.org/10.1016/S1081-1206(10)60373-0.

    Article  PubMed  Google Scholar 

  7. Moon IJ, Kim SW, Han DH, Kim ST, Min YG, Lee CH, et al. Predictive factors for the outcome of nasal septal perforation repair. Auris Nasus Larynx. 2011;38(1):52–7. https://doi.org/10.1016/j.anl.2010.05.006.

    Article  PubMed  Google Scholar 

  8. Dosen L, Haye R, Døsen LK. Nasal septal perforation 1981-2005: changes in etiology, gender and size. BMC Ear Nose Throat Disord. 2007;7(1):1. https://doi.org/10.1186/1472-6815-7-1.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Diamantopoulos II, Jones NS. The investigation of nasal septal perforations and ulcers. J Laryngol Otol. 2001;115(7):541–4.

    CAS  Article  PubMed  Google Scholar 

  10. Rettinger G, Kirsche H. Complications in septoplasty. Facial Plast Surg. 2006;22(4):289–97. https://doi.org/10.1055/s-2006-954847.

    CAS  Article  PubMed  Google Scholar 

  11. Kim DW, Egan KK, O'Grady K, Toriumi DM. Biomechanical strength of human nasal septal lining: comparison of the constituent layers. Laryngoscope. 2005;115(8):1451–3. https://doi.org/10.1097/01.mlg.0000168579.94187.f6.

    Article  PubMed  Google Scholar 

  12. Deniz M, Ciftçi Z, Işık A, Demirel OB, Gültekin E. The impact of different nasal packings on postoperative complications. Am J Otolaryngol. 2014;35(5):554–7. https://doi.org/10.1016/j.amjoto.2014.04.001.

    Article  PubMed  Google Scholar 

  13. John WS, Wu L-T. Trends and correlates of cocaine use and cocaine use disorder in the United States from 2011 to 2015. Drug Alcohol Depend. 2017;(180):376–84.

  14. Sehgal R, Resnick JM, Al-Hilli A, Mehta N, Conway T, Stratman EJ. Nasal septal and mucosal disease associated with pyoderma gangrenosum in a cocaine user. JAAD Case Rep. 2017;3(4):284–7. https://doi.org/10.1016/j.jdcr.2017.05.004.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Smith JC, Kacker A, Anand VK. Midline nasal and hard palate destruction in cocaine abusers and cocaine’s role in rhinologic practice. Ear Nose Throat J. 2002;81(3):172–7.

    PubMed  Google Scholar 

  16. •• Trimarchi M, Bertazzoni G, Bussi M. Cocaine induced midline destructive lesions. Rhinology. 2014;52(2):104–11. The author found that 4.8 of cocaine users had pathologies that mimic systemic diseases with positive anti-neutrophil cytoplasmic antibodies. They concluded that the presence of ANCA directed against human neutrophil elastase is the most distinguishing feature of cocaine-induced midline destructive lesions. https://doi.org/10.4193/Rhin.

    CAS  PubMed  Google Scholar 

  17. DeBernardis JF, Winn M, Kerkman DJ, Kyncl JJ, Buckner S, Horrom B. A new nasal decongestant, A-57219: a comparison with oxymetazoline. J Pharm Pharmacol. 1987;39(9):760–3. https://doi.org/10.1111/j.2042-7158.1987.tb06989.x.

    CAS  Article  PubMed  Google Scholar 

  18. Dokuyucu R, Gokce H, Sahan M, Sefil F, Tas ZA, Tutuk O. Systemic side effects of locally used oxymetazoline. Int J Clin Exp Med. 2015;8(2):2674–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Cervin A, Andersson M. Intranasal steroids and septum perforation—an overlooked complication? A description of the course of events and a discussion of the causes. Rhinology. 1998;36(3):128–32.

    CAS  PubMed  Google Scholar 

  20. Berg OH, Lie K, Steinsvåg SK. The effects of topical nasal steroids on rat respiratory mucosa in vivo, with special reference to benzalkonium chloride. Allergy. 1997;52(6):627–32. https://doi.org/10.1111/j.1398-9995.1997.tb01041.x.

    CAS  Article  PubMed  Google Scholar 

  21. Cervin A, Akerlund A, Greiff L, Andersson M. The effect of intranasal budesonide spray on mucosal blood flow measured with laser Doppler flowmetry. Rhinology. 2001;39(1):13–6.

    CAS  PubMed  Google Scholar 

  22. Brown H, Storey G, Jackson F. Beclomethasone dipropionate aerosol in treatment of perennial and seasonal rhinitis: a review of five years’ experience. Br J Clin Pharmacol. 1977;4(Suppl 3):283S–6S. https://doi.org/10.1111/j.1365-2125.1977.tb04522.x.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Bensch GW. Safety of intranasal corticosteroids. Ann Allergy Asthma Immunol. 2016;117(6):601–5. https://doi.org/10.1016/j.anai.2016.06.009.

    CAS  Article  PubMed  Google Scholar 

  24. Williams N. What are the causes of a perforated nasal septum? Occup Med (Lond). 2000;50(2):135–6. https://doi.org/10.1093/occmed/50.2.135.

    CAS  Article  Google Scholar 

  25. Castano R, Theriault G, Gautrin D. Categorizing nasal septal perforations of occupational origin as cases of corrosive rhinitis. Am J Ind Med. 2007;50(2):150–3. https://doi.org/10.1002/ajim.20419.

    Article  PubMed  Google Scholar 

  26. Singhal VK, Deswal BS, Singh BN. Study of skin and mucous membrane disorders among workers engaged in the sodium dichromate manufacturing industry and chrome plating industry. Indian J Occup Environ Med. 2015;19(3):129–33. https://doi.org/10.4103/0019-5278.173994.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Kuo HW, Lai JS, Lin TI. Nasal septum lesions and lung function in workers exposed to chromic acid in electroplating factories. Int Arch Occup Environ Health. 1997;70(4):272–6. https://doi.org/10.1007/s004200050218.

    CAS  Article  PubMed  Google Scholar 

  28. Bolek EC, Erden A, Kulekci C, Kalyoncu U. Rare occupational cause of nasal septum perforation: nickel exposure. Int J Occup Med Environ Health. 2017;30(6):963–7. https://doi.org/10.13075/ijomeh.1896.01019.

    PubMed  Google Scholar 

  29. Moscato G, Vandenplas O, Van Wijk RG, Malo JL, Perfetti L, Quirce S, et al. EAACI position paper on occupational rhinitis. Respir Res. 2009;10(1):16. https://doi.org/10.1186/1465-9921-10-16.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Khan S, Pujani M, Jetley S. Primary nasal tuberculosis: resurgence or coincidence—a report of four cases with review of literature. Lab Physicians. 2017;9(1):26–30.

    Article  Google Scholar 

  31. Hup AK, Haitjema T, de Kuijper G. Primary nasal tuberculosis. Rhinology. 2001;39(1):47–8.

    CAS  PubMed  Google Scholar 

  32. Butt AA. Nasal tuberculosis in the 20th century. Am J Med Sci. 1997;313(6):332–5.

    CAS  PubMed  Google Scholar 

  33. Kaur R, Kachroo K, Sharma JK, Vatturi SM, Dang A. Diagnostic accuracy of Xpert test in tuberculosis detection: a systematic review and meta-analysis. J Glob Infect Dis. 2016;8(1):32–40. https://doi.org/10.4103/0974-777X.176143.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Alobid I, Guilemany JM, Mullol J. Nasal manifestations of systemic illnesses. Curr Allergy Asthma Rep. 2004;4(3):208–16. https://doi.org/10.1007/s11882-004-0028-y.

    Article  PubMed  Google Scholar 

  35. Chaptini C, Marshman G. Leprosy: a review on elimination, reducing the disease burden, and future research. Lepr Rev. 2015;86(4):307–15.

    PubMed  Google Scholar 

  36. Ficarra G, Carlos R. Syphilis: the renaissance of an old disease with oral implications. Head Neck Pathol. 2009;3(3):195–206. https://doi.org/10.1007/s12105-009-0127-0.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Newman L, Rowley J, Vander Hoorn S, Wijesooriya NS, Unemo M, Low N, et al. Global estimates of the prevalence and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting. PLoS One. 2015;10(12):e0143304. https://doi.org/10.1371/journal.pone.0143304.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Primary and secondary syphilis—United States, 2000-2001. MMWR Morb Mortal. Wkly Rep. 2002;51(43):971–3.

    Google Scholar 

  39. Pletcher SD, Cheung SW. Syphilis and otolaryngology. Otolaryngol Clin N Am. 2003;36(4):595–605, vi. https://doi.org/10.1016/S0030-6665(03)00025-2.

    Article  Google Scholar 

  40. Clement ME, Okeke NL, Hicks CB. Treatment of syphilis: a systematic review. JAMA. 2014;312(18):1905–17. https://doi.org/10.1001/jama.2014.13259.

    Article  PubMed  Google Scholar 

  41. Fokkens WJ, Lund VJ, Mullol J, et al. European position paper on rhinosinusitis and nasal polyps 2012. Rhinol Suppl. 2012;23:1–298.

    Google Scholar 

  42. Nsagha DS, Bamgboye EA, Assob JCN, Njunda AL, Kamga HLF, Zoung-Kanyi Bissek A-C, et al. Elimination of leprosy as a public health problem by 2000 AD: an epidemiological perspective. Pan Afr Med J. 2011;9:4.

    PubMed  PubMed Central  Google Scholar 

  43. Rejali SD, Simo R, Saeed AM, de Carpentier J. Acquired immune deficiency syndrome (AIDS) presenting as a nasal septal perforation. Rhinology. 1999;37(2):93–5.

    CAS  PubMed  Google Scholar 

  44. Jaimes A, Muvdi S, Alvarado Z, Rodríguez G. Perforation of the nasal septum as the first sign of histoplasmosis associated with AIDS and review of published literature. Mycopathologia. 2013;176(1–2):145–50. https://doi.org/10.1007/s11046-013-9662-z.

    Article  PubMed  Google Scholar 

  45. Middlebrooks EH, Frost CJ, De Jesus RO, Massini TC, Schmalfuss IM, Mancuso AA. Acute invasive fungal rhinosinusitis: a comprehensive update of CT findings and design of an effective diagnostic imaging model. AJNR Am J Neuroradiol. 2015;36(8):1529–35. https://doi.org/10.3174/ajnr.A4298.

    CAS  Article  PubMed  Google Scholar 

  46. Payne SJ, Mitzner R, Kunchala S, Roland L, McGinn JD. Acute invasive fungal rhinosinusitis: a 15-year experience with 41 patients. Otolaryngol Head Neck Surg. 2016;154(4):759–64. https://doi.org/10.1177/0194599815627786.

    Article  PubMed  Google Scholar 

  47. Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum. 2013;65(1):1–11. https://doi.org/10.1002/art.37715.

  48. Romero-Gómez C, Aguilar-García JA, García-de-Lucas MD, Cotos-Canca R, Olalla-Sierra J, García-Alegría JJ, et al. Epidemiological study of primary systemic vasculitides among adults in southern Spain and review of the main epidemiological studies. Clin Exp Rheumatol. 2015;33(2 Suppl 89):S-11-8.

    PubMed  Google Scholar 

  49. Gómez-Puerta JA, Hernández-Rodríguez J, López-Soto A, Bosch X. Antineutrophil cytoplasmic antibody-associated vasculitides and respiratory disease. Chest. 2009;136(4)1101–1111. https://doi.org/10.1378/chest.08-3043.

  50. Hernandez-Rodriguez J, Hoffman GS, Koening CL. Surgical interventions and local therapy for Wegener’s granulomatosis. Curr Opin Rheumatol. 2010;22(1):29–36. https://doi.org/10.1097/BOR.0b013e328333e9e9.

    Article  PubMed  Google Scholar 

  51. Guntupalli L, Patel K, Faraji F, Brunworth JD. Autoimmune-related nasal septum perforation: a case report and systematic review. Allergy Rhinol (Providence). 2017;8(1):40–4. https://doi.org/10.2500/ar.2017.8.0191.

    Article  Google Scholar 

  52. Cannady SB, Batra PS, Koening C, Lorenz RR, Citardi MJ, Langford C, et al. Sinonasal Wegener granulomatosis: a single-institution experience with 120 cases. Laryngoscope. 2009;119(4):757–61. https://doi.org/10.1002/lary.20161.

    Article  PubMed  Google Scholar 

  53. Gubbels SP, Barkhuizen A, Hwang PH. Head and neck manifestations of Wegener’s granulomatosis. Otolaryngol Clin N Am. 2003;36(4):685–705. https://doi.org/10.1016/S0030-6665(03)00023-9.

    Article  Google Scholar 

  54. Devaney KO, Travis WD, Hoffman G, Leavitt R, Lebovics R, Fauci AS. Interpretation of head and neck biopsies in Wegener's granulomatosis. A pathologic study of 126 biopsies in 70 patients. Am J Surg Pathol. 1990;14(6):555–64.

  55. Valeyre D, Prasse A, Nunes H, Uzunhan Y, Brillet P-Y, Müller-Quernheim J. Sarcoidosis. Lancet. 2014;383(9923):1155–67. https://doi.org/10.1016/S0140-6736(13)60680-7.

    Article  PubMed  Google Scholar 

  56. Judson MA. The clinical features of sarcoidosis: a comprehensive review. Clin Rev Allergy Immunol. 2015;49(1):63–78. https://doi.org/10.1007/s12016-014-8450-y.

    Article  PubMed  Google Scholar 

  57. Lawson W, Jiang N, Cheng J. Sinonasal sarcoidosis: a new system of classification acting as a guide to diagnosis and treatment. Am J Rhinol Allergy. 2014;28(4):317–22. https://doi.org/10.2500/ajra.2014.28.4061.

    Article  PubMed  Google Scholar 

  58. Kusyairi KA, Gendeh BS, Sakthiswary R, Shaharir SS, Haizlene AH, Yusof KH. The spectrum of nasal involvement in systemic lupus erythematosus and its association with the disease activity. Lupus. 2016;25(5):520–4. https://doi.org/10.1177/0961203315622279.

    CAS  Article  PubMed  Google Scholar 

  59. Lisnevskaia L, Murphy G, Isenberg D. Systemic lupus erythematosus. Lancet. 2014;384(9957):1878–88. https://doi.org/10.1016/S0140-6736(14)60128-8.

    Article  PubMed  Google Scholar 

  60. Hicklin DJ, Ellis LM. Role of the vascular endothelial growth factor pathway in tumor growth and angiogenesis. J Clin Oncol. 2005;23(5):1011–27. https://doi.org/10.1200/JCO.2005.06.081.

    CAS  Article  PubMed  Google Scholar 

  61. Geltzeiler M, Steele TO. Nasal septal perforation secondary to systemic bevacizumab. Am J Otolaryngol. 2017;38(3):354–5. https://doi.org/10.1016/j.amjoto.2017.01.018.

    Article  PubMed  Google Scholar 

  62. Ramiscal JA, Jatoi A. Bevacizumab-induced nasal septal perforation: incidence of symptomatic, confirmed event(s) in colorectal cancer patients. Acta Oncol. 2011;50(4):578–81. https://doi.org/10.3109/0284186X.2010.537692.

    CAS  Article  PubMed  Google Scholar 

  63. D’Amico M, Pagano M, Pasa A, Puntoni M, Clavarezza M, Gennari A, et al. An observational study of nasal cavity toxicity in cancer patients treated with bevacizumab. Expert Opin Drug Saf. 2014;13(11):1437–42. https://doi.org/10.1517/14740338.2014.960388.

    Article  PubMed  Google Scholar 

  64. Reategui Schwarz E, Oikonomou KG, Reynolds M, Kim J, Balmiki RL, Sterling SA. Extranodal NK/T-cell lymphoma, nasal type, presenting as refractory pseudomonas aeruginosa facial cellulitis. J Investig Med High Impact Case Rep. 2017;5(3):2324709617716471.

    PubMed  PubMed Central  Google Scholar 

  65. Au W, Pang A, Choy C, Chim C, Kwong YL. Quantification of circulating Epstein-Barr virus (EBV) DNA in the diagnosis and monitoring of natural killer cell and EBV-positive lymphomas in immunocompetent patients. Blood. 2004;104(1):243–9. https://doi.org/10.1182/blood-2003-12-4197.

    CAS  Article  PubMed  Google Scholar 

  66. DiLeo MD, Miller RH, Rice JC, Butcher RB. Nasal septal squamous cell carcinoma: a chart review and meta-analysis. Laryngoscope. 1996;106(10):1218–22. https://doi.org/10.1097/00005537-199610000-00008.

    CAS  Article  PubMed  Google Scholar 

  67. Alobid I. Endoscopic closure of septal perforation. Acta Otorrinolaringológica Española. 2017. (In Press).

  68. Mullace M, Gorini E, Sbrocca M, Artesi L, Mevio N. Management of nasal septal perforation using silicone nasal septal button. Acta Otorhinolaryngol Ital. 2006;26(4):216–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  69. Pedroza F, Patrocinio LG, Arevalo O. A review of 25-year experience of nasal septal perforation repair. Arch Facial Plast Surg. 2007;9(1):12–8. https://doi.org/10.1001/archfaci.9.1.12.

    Article  PubMed  Google Scholar 

  70. Watson D, Barkdull G. Surgical management of the septal perforation. Otolaryngol Clin N Am. 2009;42(3):483–93. https://doi.org/10.1016/j.otc.2009.03.011.

    Article  Google Scholar 

  71. Gras-Cabrerizo JR, García-Garrigós E, Ademá-Alcover JM, Sarandeses-Garcia A, Martel-Martin M, Montserrat-Gili JR, et al. A unilateral septal flap based on the anterior ethmoidal artery (Castelnuovo’s flap): CT cadaver study. Surg Radiol Anat. 2016;38(6):723–8. https://doi.org/10.1007/s00276-015-1610-9.

    Article  PubMed  Google Scholar 

  72. Goh AY, SSM H. Different surgical treatments for nasal septal perforation and their outcomes. J Laryngol Otol. 2007;121(5):419–26. https://doi.org/10.1017/S002221510700566X.

    CAS  Article  PubMed  Google Scholar 

  73. •• Alobid I, Castelnuovo P. Nasoseptal perforations: endoscopic repair techniques. Thieme 2017. ISBN 978–3- 13-205391- 5. eISBN: 9783132054011. Atlas of dissection with a complete review of nasal anatomy, evaluation of NSP, etiologies, and finally, all endoscopic approaches available for the repair of nasoseptal perforations. Approaches are explained step by step using photographs from fresh cadaver dissections made by the authors.

  74. Pignatari S, Nogueira JF, Stamm AC. Endoscopic rossover flap technique for nasal septal perforations. Otolaryngol Head Neck Surg. 2010;142(1):132–4. https://doi.org/10.1016/j.otohns.2009.08.024.

    Article  PubMed  Google Scholar 

  75. Lee DH, Yoon TM, Lee JK, Joo YE, Kim IY, Jang WY, et al. Clinical utility of the inferior turbinate flaps in the reconstruction of the nasal septum and skull base. J Craniofac Surg. 2012;23(4):e322–6. https://doi.org/10.1097/SCS.0b013e3182543410.

    Article  PubMed  Google Scholar 

  76. •• Alobid I, Mason E, Solares CA, Prevedello D, Enseñat J, De Notaris M, et al. Pedicled lateral nasal wall flap for the reconstruction of the nasal septum perforation. A radio-anatomical study. Rhinology. 2015;53(3):235–41. Radio-anatomical study in 40 de-identified CT angiographies. In a cadaver study, 20 hemi-cranial sagittal sections were also analyzed. A clinical study with endoscopic closure of a large NSP in three patients. The study demonstrates that anterior and posterior lateral wall flaps are viable alternatives to repair symptomatic large defects, and each one may cover approximately up to three quarters of the nasal septum. https://doi.org/10.4193/Rhin14.042.

    PubMed  Google Scholar 

  77. Alobid I, Langdon C, Lopez-Chacón M, Enseñat J, Carrau R, Bernal-Sprekelsen M, et al. Total septal perforation repair with pericranial flap: radio-anatomical and clinical findings. Laryngoscope. 2017. https://doi.org/10.1002/lary.26966.

  78. Carrau RL. Pericranial flap. In: Alobid I, Bernal-Sprekelsen M E (eds) Anatomical landmarks for endoscopic approaches to the paranasal sinuses and the skull base: instructional step-by-step dissection guide. Thieme (2017). ISBN 978–3- 13-201881-5. eISBN: 978–3- 13-201891- 4.

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Funding

JHR is supported by the Ministerio de Economía, Industria y Competitividad (SAF 17/88275-R) and Marató TV3 (201507).

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Affiliations

  1. Department of Otorhinolaryngology Rhinology and Skull Base. Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain

    Carla Pereira, Alfonso Santamaría, Cristobal Langdon, Mauricio López-Chacón & Isam Alobid

  2. Department of Otorhinolaryngology, Barros Luco Trudeu Hospital, Santiago, Chile

    Carla Pereira

  3. Clinical and Experimental Respiratory Immunoallergy, IDIBAPS; CIBERES, Barcelona, Spain

    Alfonso Santamaría, Cristobal Langdon, Mauricio López-Chacón & Isam Alobid

  4. Vasculitis Research Unit, Department of Autoimmune Diseases, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain

    José Hernández-Rodríguez

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  1. Carla Pereira
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  2. Alfonso Santamaría
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Correspondence to Isam Alobid.

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Pereira, C., Santamaría, A., Langdon, C. et al. Nasoseptal Perforation: from Etiology to Treatment. Curr Allergy Asthma Rep 18, 5 (2018). https://doi.org/10.1007/s11882-018-0754-1

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Keywords

  • Septal perforation
  • Nasal septum perforation
  • Endonasal endoscopic surgery
  • Nasal mucosa