Is the Preoperative Septal Patch Test Helpful for Determining the Effects After Nasal Septal Perforation Closure?

Abstract

Nasal septal perforation (NSP) closure is a challenging procedure. In the case of a large NSP, it may be necessary to use tissue from outside the nose; therefore, the decision to perform NSP closure should be made carefully. The indication for NSP closure is whether the patient has nasal symptoms due to the NSP; however, the causes of nasal obstruction are diverse and can be difficult to determine. We performed the septal patch test (SPT) as a simple examination to determine if NSP closure will improve nasal symptoms. The septal patch is created by cutting a piece of filter paper slightly larger than the NSP and adjusting it for a proper fit. Two septal patches are prepared and used to cover the NSP from both the left and right nasal cavities. Nasal breathing symptoms are evaluated using a visual analog scale (N-VAS) before and 3 minutes after SPT. We evaluated 6 cases of NSP. The average N-VAS score was 1.5 preoperatively, 8.16 after SPT, and 8.16 postoperatively. The maximum and minimum NSP sizes were 35 and 5 mm, respectively. Nasal symptoms after SPT were similar to those after NSP closure. We believe that SPT is useful for evaluating the symptom-relieving effects of NSP closure procedures. If a patient with nasal obstruction also has an NSP, performing SPT alongside other assessments may help identify the cause of the nasal obstruction.