Ep. 278 Comprehensive Evaluation and Surgical Management of Nasal Septal Perforations with Dr. Oswaldo Henriquez

Septal perforations can be deceptively challenging, with a wide range of etiologies, symptoms, and treatment options to consider. In this episode of BackTable ENT and Allergy podcast, hosts Dr. Ashley Agan and Dr. Gopi Shah interview Dr. Oswaldo Henriquez, a board-certified otolaryngologist and rhinologist at WellStar Health System in Atlanta, to explore the complexities of evaluating and managing nasal septal perforations. The conversation covers how perforation size and location shape symptoms, the most common causes including iatrogenic trauma and chronic nose picking, and a thorough, stepwise approach to diagnosis and treatment. ---Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction03:01 - Septal Perforations Overview07:58 - Causes and Risk Factors13:26 - History Red Flags and Differential Diagnosis16:28 - Exam and Documentation Tips21:22 - Labs Biopsy and Imaging Workup31:19 - Conservative Care and Septal Buttons34:20 - Surgery Candidacy and Counseling41:35 - Surgical Techniques Landscape47:38 - Scaffolds and Grafts49:07 - Septal Blood Supply Map53:00 - CAT Scan Planning Tips55:15 - AEA Flap Technique01:05:22 - Real Case Walkthrough01:10:41 - Postop Care and Swelling01:20:44 - Pitfalls and Success Rates01:24:09 - Wrap Up --- More about this episodeDr. Henriquez outlines the key components of a comprehensive workup, including endoscopic exam, measurement, biopsy, and CT imaging for surgical planning. He discusses management options from conservative care and septal buttons to advanced endoscopic pedicled flap repairs, sharing insight on surgical techniques, success rates, splinting, and post-op care. The episode provides practical tips for physicians at any career stage looking to refine their approach to septal perforations, from diagnosis through recovery. --- ResourcesENT Animationshttps://www.youtube.com/@Dr.IsamAlobid --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app