Abstract
Nasal septal flaps are a convenient source of lining and support in nasal reconstructive surgery. Most technical descriptions of these flaps demonstrate designs that result in septal perforation. By properly planning the design of a contralateral mucosal flap, septal perforation can be avoided when septal chondromucosal flaps are used. Eight such flaps have been used by the author, four to provide lining and support in total nasal reconstruction after removal of very large basal cell cancers, and four to repair cerebrospinal fluid leaks. None of these eight patients developed septal perforations. Details of the operative technique and illustrative cases are presented.

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