Repair of Operative Single-Sided Nasal Septal “Déchirure” with Mucosa-on-Cartilage Island Graft: Tandoor Graft

Mucop erich ondri al/pe riost al flap lacerations (déchirures) and even flap loss are relatively common in nasal septal surgery. Most flap injuries warrant little to no further surgical action; however, bilateral septal tears or large mucosal defects necessitate reconstruction modalities such as endonasal suturing or interpositional graft placement. Treating an easily made condition might add a few extra minutes to the operative time, yet neglecting or failing to recognize these issues could result in iatrogenic nasal septal perforations, which can be quite problematic for both patients and surgeons. In this case report, a large, right-sided mucoperichondrial defect during septal surgery, and the intraoperative treatment with a mucosa-on-cartilage island graft, which is named “tandoor graft,” is reported. The defect resulted from inadequate elevation of the lower tunnel due to a severely acute vomerine spur. A 3-month postoperative follow-up endoscopic view is also provided. There are copious treatment approaches to septal flap injuries and septal perforations in the literature. This novel technique could be a viable alternative that surgeons could resort to when faced with large mucosal defects and might contribute to the plethora of options available.