{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T13:26:47Z","timestamp":1783517207523,"version":"3.55.0"},"reference-count":20,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n Anterior nasal septal perforations (NSPs) can cause significant morbidity and are often challenging to repair in revision settings where posterior septal mucosa lack integrity, are difficult to raise, or are traumatized. We describe an anteriorly pedicled nasal floor mucoperiosteal flap based on the superior labial artery (SLA) and report anatomical and symptomatic outcomes in patients where traditional anterior ethmoid and greater palatine artery flaps are not readily available.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A case series of consecutive adult patients undergoing endoscopic NSP repair using an SLA\u2010based anterior pedicled floor flap was performed. Outcomes included anatomical closure, Miglani endoscopic score, symptom evaluation with SNOT\u201022 and nasal subdomain scores. The definition of outcome was defined by both resolution of clinical symptoms and anatomical closure, with \u201ccomplete\u201d being both.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Twenty\u2010one patients (age 41.5\u2009\u00b1\u200910.9\u2009years; 57.1% female) were followed for 9.4\u2009\u00b1\u20093.6\u2009months. Most perforations were anterior (85.7%) and iatrogenic (surgical trauma) in etiology, with a mean area of 92.6\u2009\u00b1\u200971.9 mm\n 2<\/jats:sup>\n . Anatomical closure was achieved in 90.5 [71.1\u201397.3]% of cases, with partial closure in 9.5 [2.7\u201328.9]%. Endoscopy assessment improved (Miglani 3.14\u2009\u00b1\u20091.56 v 0.62\u2009\u00b1\u20090.86;\n p<\/jats:italic>\n \u2009<\u20090.001). Symptoms improved in both nasal subdomain (14.1\u2009\u00b1\u20096.2 v 3.5\u2009\u00b1\u20093.2,\n p<\/jats:italic>\n \u2009<\u20090.001) and SNOT\u201022 (38.6\u2009\u00b1\u200921.8 v 9.8\u2009\u00b1\u200911.5,\n p<\/jats:italic>\n \u2009<\u20090.001). Complete success (anatomical closure with symptom resolution) was achieved in 90.5 [71.1\u201397.3]%.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The SLA\u2010based nasal floor flap provides high closure rates and symptomatic improvement in NSP cases where traditional septal flaps are not feasible.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n 4.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/lary.70690","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T13:04:47Z","timestamp":1783515887000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Superior Labial Artery Flap for Septal Perforation Repair: The Boxer's Flap"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3345-9486","authenticated-orcid":false,"given":"Nicholas J.","family":"Campion","sequence":"first","affiliation":[{"name":"Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales Sydney Australia"},{"name":"Faculty of Medicine and Health Sciences, Macquarie University Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6537-0510","authenticated-orcid":false,"given":"Zhanna","family":"Mokoyan","sequence":"additional","affiliation":[{"name":"Department of Ear, Nose, and Throat Diseases The First Moscow State Medical University, Sechenov University Moscow Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktoriya","family":"Stepanova","sequence":"additional","affiliation":[{"name":"Central State Medical Academy Vasilenko Private ENT\u2010Center Moscow Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2557-6017","authenticated-orcid":false,"given":"Isam","family":"Alobid","sequence":"additional","affiliation":[{"name":"Rhinology and Skull Base Surgery Unit, ENT Department Hospital Clinic, IDIBAPS, CIBERES, Universitat de Barcelona Barcelona Spain"},{"name":"Centro M\u00e9dico Teknon Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6942-8975","authenticated-orcid":false,"given":"Richard J.","family":"Harvey","sequence":"additional","affiliation":[{"name":"Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales Sydney Australia"},{"name":"Faculty of Medicine and Health Sciences, Macquarie University Sydney Australia"},{"name":"School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, University of New South Wales Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yury","family":"Rusetsky","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Central State Medical Academy Moscow Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"issue":"9","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1002\/alr.22965","article-title":"Surgical Repair of Nasal Septal Perforations: A Systematic Review and Meta\u2010Analysis","volume":"12","author":"Fermin J. M.","year":"2022","journal-title":"International Forum of Allergy & Rhinology"},{"issue":"7","key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1002\/lary.30447","article-title":"How to Improve the Outcomes of Anterior Septal Perforations Repair With Combined Flaps","volume":"133","author":"Garaycochea O.","year":"2023","journal-title":"Laryngoscope"},{"issue":"2","key":"e_1_2_13_4_1","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1002\/lary.29748","article-title":"Extended Anterior Ethmoidal Artery Flap: Novel Endoscopic Technique for Large Septal Perforation","volume":"132","author":"Santamaria\u2010Gadea A.","year":"2022","journal-title":"Laryngoscope"},{"issue":"6","key":"e_1_2_13_5_1","doi-asserted-by":"crossref","first-page":"2115","DOI":"10.1007\/s00405-020-06230-1","article-title":"Greater Palatine Artery Pedicled Flap for Nasal Septal Perforation Repair: Radiological Study and Case Series","volume":"278","author":"Santamaria\u2010Gadea A.","year":"2021","journal-title":"European Archives of Oto\u2010Rhino\u2010Laryngology"},{"issue":"1","key":"e_1_2_13_6_1","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1177\/00034894231178964","article-title":"Factors Affecting the Surgical Outcome in Nasal Septal Perforation Repair","volume":"133","author":"Joo H. A.","year":"2024","journal-title":"Annals of Otology, Rhinology, and Laryngology"},{"issue":"1","key":"e_1_2_13_7_1","doi-asserted-by":"crossref","DOI":"10.3390\/cancers16010169","article-title":"Reconstruction of the Anterior Skull Base Using the Nasoseptal Flap: A Review","volume":"16","author":"Werner M. T.","year":"2023","journal-title":"Cancers"},{"key":"e_1_2_13_8_1","article-title":"International Consensus Statement on Nasal Septal Perforation","author":"Isam Alobid O. G.","journal-title":"Rhinology"},{"issue":"7","key":"e_1_2_13_9_1","doi-asserted-by":"crossref","first-page":"3049","DOI":"10.1002\/lary.31286","article-title":"Assessment of a Novel Tool for the Clinical Grading of Nasal Septal Perforation","volume":"134","author":"Miglani A.","year":"2024","journal-title":"Laryngoscope"},{"issue":"3","key":"e_1_2_13_10_1","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1177\/1945892418816959","article-title":"Septal Perforation Repair Utilizing an Anterior Ethmoidal Artery Flap and Collagen Matrix","volume":"33","author":"Cavada M. N.","year":"2019","journal-title":"American Journal of Rhinology & Allergy"},{"issue":"1","key":"e_1_2_13_11_1","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1177\/19458924211012120","article-title":"Long Term Outcomes of Nasoseptal Perforation Repair With an Anterior Ethmoidal Artery Flap","volume":"36","author":"Zocchi J.","year":"2022","journal-title":"American Journal of Rhinology & Allergy"},{"issue":"3","key":"e_1_2_13_12_1","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1017\/S0022215117001499","article-title":"Collagen Matrix as an Inlay in Endoscopic Skull Base Reconstruction","volume":"132","author":"Oakley G. M.","year":"2018","journal-title":"Journal of Laryngology and Otology"},{"key":"e_1_2_13_13_1","doi-asserted-by":"crossref","first-page":"2767","DOI":"10.1007\/s00405-025-09913-9","article-title":"Surgical Repair of Large Nasal Septal Perforation: A Systematic Review and Meta\u2010Analysis","volume":"283","author":"Cheung M. 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M.","year":"1996","journal-title":"Archives of Otolaryngology \u2013 Head & Neck Surgery"},{"issue":"10","key":"e_1_2_13_20_1","article-title":"Analyzing the Anatomical Characteristics of the Facial Artery Branches: A Human Cadaveric Study","volume":"16","author":"Metilda G.","year":"2024","journal-title":"Cureus"},{"issue":"5","key":"e_1_2_13_21_1","doi-asserted-by":"crossref","first-page":"197","DOI":"10.7181\/acfs.2025.0030","article-title":"Anteriorly\u2010Based Nasal Floor Mucoperiosteal Flap for Septal Perforation","volume":"26","author":"Oraby T.","year":"2025","journal-title":"Archives of Craniofacial Surgery"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70690","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.70690","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70690","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T13:04:50Z","timestamp":1783515890000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.70690"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,8]]},"references-count":20,"alternative-id":["10.1002\/lary.70690"],"URL":"https:\/\/doi.org\/10.1002\/lary.70690","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,8]]},"assertion":[{"value":"2026-03-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"lary.70690"}}