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Objective To improve the closure rate of large nasal septal perforations. Methods Using an endoscope, complex mucoperichondrial/mucoperiosteal flaps on one side and free tissue graft on the other, we designed a procedure to repair large nasal septal perforations.Results In our series, 8 patients were operated on with this procedure, resulting in complete closure of the perforation and subsequent relief of symptoms. Conclusion This technique may be used as an alter*$native for the repair of large nasal septal perforations.