No framework

Posterior septal advancement

For large anterior perforations when no framework remains: the back of the septum is advanced forward to fill the hole.

Written by the Septal Perforation team, patients, from the sources cited · Reviewed by doctors · Updated 2 November 2026 · Method and sources

Trade-off

Rear defect

The technique leaves a defect at the back of the septum.

Moreno-Luna et al., ch. 15, Springer 2026.

In brief

For large anterior perforations with no framework left.

Leaves a defect at the back of the septum.

Long learning curve, few published cases.

On this page Principle Who for After Results Questions for the surgeon Questions Sources

The principle

When cartilage and bone have gone around a large anterior hole, the usual flaps have no support. This technique advances the back part of the septum, with its mucosa, to rebuild the front.

Source: Moreno-Luna, Martin-Jimenez, Sanchez-Gomez, ch. 15, in Alobid (ed.), Septal Perforation Repair, Springer 2026.

Who it is for, and who it is not for

Indicated

Large perforation at the front.
No framework left.

Contraindicated or poorly suited

Less experienced teams: the learning curve is long.
The defect left at the back should be discussed before surgery.

After surgery

1No forceful nose blowingRecommended by the chapter to protect the repair.

Published results

Few cases are published: the results remain to be confirmed in larger series.

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

How many times have you performed this technique?
What will happen to the back of my septum?
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 not use a standard flap?

Without cartilage or bone around the hole, the mucosa does not lift properly and standard flaps have no support.

Sources

Every figure on this page comes from one of these publications. The year is the year of publication.

2026Septal Advancement Technique for Large Anterior Septal Perforations Without Osseocartilaginous SupportMoreno-Luna, Martin-Jimenez, Sanchez-Gomez · ch. 15, in Alobid I. (ed.), Septal Perforation Repair: State-of-the-Art, Springer Nature