Christian Stephan Betz

Objective Nasal septum perforation (NSP) is a common condition affecting ~1.2% of the general population and is still considered challenging to treat. Therapeutic strategies range from conservative local treatments and septal button closures to over 40 different surgical approaches. This study aimed to present a novel secure approach. Methods We describe our novel and unique NSP closure approach using a “fascia taco,” in which conchal cartilage is enveloped by temporalis fascia like a taco and splints are left in place for 6–8 weeks. A review of patient charts was conducted and questionnaires including the German‐SNOT‐22 and D‐NOSE were sent by mail to all eligible patients who received a fascia taco between 2016 and 2021. Results Thirty‐three patients were identified. The questionnaire response rate was 54.5%. The mean operative time (cut to sew) for all patients who only underwent NSP closure was 90.4 min. The overall success rate in terms of postoperative NSP closure was 81.8%. We found an apparent but nonsignificant association between closure failure and smoking (failure rate 66.6% in smokers vs. 15.4% in nonsmokers; X 2 = 3.4188, p = .064). Questionnaire analysis showed a significant postoperative reduction of mean values in D‐NOSE from 60.8 to 33.1 ( p = .009) and in German‐SNOT‐22 from 38.6 to 21.2 ( p = .005). Conclusion The fascia taco technique is an easy‐to‐apply, safe procedure for NSP closure that is short in duration and associated with a low morbidity, resulting in excellent patient satisfaction. Level of Evidence 4.