Bilateral nasoseptal flaps
Two flaps fed from the back, one on each side, with a temporalis fascia graft between them. An option for large perforations, less suited to holes very far forward.
Written by the Septal Perforation team, patients, from the sources cited · Reviewed by doctors · Updated 2 November 2026 · Method and sources
In brief
Two posteriorly based flaps and a temporalis fascia graft between them.
75% closure above 2 cm in a small series.
An interposition graft must always be fully covered by vascularised mucosa.
The principle
Each flap keeps its artery at the back of the nose and is advanced towards the hole. Between the two, a temporalis fascia graft (a membrane taken near the temple) serves as a middle layer.
Key principle: an interposition graft must always be fully covered by vascularised mucosa.
Who it is for, and who it is not for
After surgery
- 1Antibiotics7 to 10 days depending on the team.
Published results
A small series only: an order of magnitude, not a guarantee.
Published series come from very experienced teams: they are ceilings, not promises. [[success-rates|The real success rates ›]]
Note before the consultation
Questions to ask the surgeon
- Is my hole too far forward for this technique?
- Will the graft be fully covered on both sides?
- How many times a year do you perform this technique, and with what closure rate at 1 year? (All the questions: the guide.)
Frequently asked questions
Why a fascia graft?
It serves as a middle layer between the two flaps. To heal well, it must be fully covered by vascularised mucosa.
Sources
Every figure on this page comes from one of these publications. The year is the year of publication.
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