Mohamed Osama Hegazy
Damietta ENT Center, Egypt
DR. Mohamed Osama Hegazy is an otorhinolaryngologist, from Damietta ,Egypt. He is the owner and manager of Damietta ENT Center which is one of the biggest ENT centers in Egypt.he took his M.Sc from Benha university and the thesis was about uses of coblation in management of Obstructive sleep apnea under local anaethesia. His main expertise are in Endoscopic Nasal surgery especially those done under local anaethesia.Hegazy now is Instructor in biggest Basic&advanced FESS workshops in Egypt (last was in military medical academy Nov 2016 ), and a guest speaker in biggest Rhinology conferences in Egypt(like RhinoEgypt conference).
Surgery for repair of a septal perforation is one of the most difficult , annoying, bad outcome surgery for an ENT surgeon.
My objective is to let rhinologists know that there is a technique that may help with good results in certain types of perforations.
Making a good surgery needs certain steps to get a great outcome,1st is good infiltration with xylocaine-adrenalin solution to get good decongestion and hydro dissection, 2nd is refreshing the edges of the perforation all around, 3rd is elevating the right nasal septal flap, 4th is freeing the lower edge of the flap, 5th is freeing posterior edge of the flap to create a superiorly based flap taking its blood supply from anterior ethmoidal artery, 6th is anterior rotation of the flap, 7th is suturing the flap using 3/0 sutures> this procedure could be done under general anesthesia or local anesthesia with moderate sedation.
Advantage of this technique is that you have vascular flap ensure good graft taking
On the other hand we face some limitations like that you should have a cartilaginous rim to get good fixation of the flap and good healing.
Finally we can say that using anterior ethmoidal artery flap in repairing anterior septal perforation is a good option with good post-operative results.