PMC3199829_01
Nasal tuberculosis. Region of the nasal choanae (C). Easily-bleeding membranes are visible in the nasopharynx and at the dorsal septum (S).
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F1
Small perforations (type A) can be closed by exchange of cartilage as demonstrated in HIV positive patient (Figure 2 (Fig. 2)).
Active Wegener's granulomatosis. Massive crusting and inflammation of the nasal mucosa.
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F3
Larger perforations (type C) can be closed by cartilage implant and bilateral inferior turbinate flaps as demonstrated in a patient with WG in remission (Figure 4 (Fig. 4)).
Microscopic Polyangiitis. Prominent vessels at the area II in a patient suffering from recurrent episodes of epsitaxis.
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F5
According to our personal concept surgical approach and technique are dependent on the localization and the size of a perforation (Figure 6 (Fig. 6)).
Graduation of nasal septal perforations. Type A: small perforation at the area I (<1 cm in diameter). Type B large perforation at the areas I and II (about 1-1.5 cm in diameter). Type C: Large perforation at the area II and III (>1.5 cm in diameter).
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F6
Type B perforations can be closed using bipedicled gingivobuccal flaps (Figure 7 (Fig. 7)).