Success rates of septal perforation repair
Success depends above all on who operates. The good news first: with specialists, more than 9 perforations in 10 close. Between an ENT who closes one perforation a year and an expert centre that closes fifty, the gap is not a few points: it is double. The sourced figures below show both realities, and why the choice of surgeon matters more than the size of the hole.
Written by the Septal Perforation team, patients, from the sources cited · Reviewed by doctors · Updated 2 November 2026 · Method and sources
An anonymous US survey gives 31 to 84% depending on size. This is the reality of an operation done occasionally.
A 2 cm perforation is not doomed to 40%: that is the figure for an occasional operator. In expert hands, more than 9 in 10 close.
How to read a success rate
A percentage on its own says almost nothing. Before comparing two figures, check four things.
What “success” means
Complete closure seen on endoscopy is not the same as better symptoms. Good series report both, separately: 95% closure and 90% symptom control, for example, in the British series of 154 patients.
Follow-up
A perforation can reopen months later. A rate measured when the splints come out overstates the result: it takes at least 12 months. The Ulm series reports 72% durable closure at 67 months.
Size
The same surgeon does not get the same rate for a 5 mm hole and a 3 cm hole. Always ask for the rate for a perforation of your size.
Number of patients
A 100% rate in 10 selected patients is worth less than 92% in 150 consecutive patients. Look at the sample size, and whether every operated patient was seen again.
What makes a closure fail
- Size, and above all height: beyond 2 cm, or when the hole is high, more lining is needed than the septum can provide; for a septum that is almost destroyed, tissue is brought in from elsewhere, such as the pericranial flap.
- Lack of support: when almost no cartilage is left, an interposition graft becomes essential.
- Smoking: the only statistically significant failure factor in several series.
- A cause that is still active: cocaine, sprays, uncontrolled inflammatory disease.
- Damaged lining from previous operations, repeated cautery or infection.
Questions to ask about their figures
- How many perforations do you close each year?
- What is your closure rate at 12 months for a perforation of my size and position?
- Is that rate published? Where can I read it?
- How many of your patients were seen again at one year?
- What happens if it fails: is a second operation possible, and with which technique?
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