Trilayer temporalis fascia interposition graft: A reliable technique for nasal septal perforation repair

• Published in: American journal of otolaryngology 2023-07, Vol.44 (4), p.103883-103883, Article 103883
• Main Authors: Hadford, Stephen P., Ciolek, Peter J., Genther, Dane J.
• Format: Article
• Language: English
• Subjects: Fascia - transplantation; Humans; Nasal septal perforation; Nasal Septal Perforation - surgery; Nasal Septum - surgery; Polydioxanone plate; Postoperative Complications - surgery; Retrospective Studies; Rhinoplasty; Rhinoplasty - methods; Septal perforation repair; Surgical Flaps; Temporalis fascia graft; Treatment Outcome
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/j.amjoto.2023.103883

Nasal septal perforation (NSP) repair is a complex procedure with variable techniques and success rates. In this study we describe NSP repair using a trilayer interposition graft of temporalis fascia and thin polydioxanone (PDS) plate without intranasal flaps and report outcomes in our patient population. IRB-approved retrospective review of 20 consecutive patients presenting to a tertiary medical center with NSP from September 2018 to December 2020 and who underwent NSP repair via our trilayer temporalis fascia interposition graft. De-identified patient data was obtained from the medical record and stored on an encrypted secure server. Descriptive statistics were examined for each variable. All 20 NSP repairs demonstrated durable repair with complete mucosal coverage at last follow-up (average 7 months). Complete resolution of preoperative symptoms was achieved in 85 % of patients, with partial resolution in the remaining 15 %. Of the 20 perforations 25 % were small (2 cm). The only surgical complication was a single intranasal synechiae. No graft harvest site complications were noted. The application of a trilayer temporalis fascia - PDS plate interposition graft without intranasal flaps is highly effective for repair of NSP. •Current methods of nasal septal perforation repair are technically complex.•Current methods of nasal septal perforation repair have variable success rates.•Septal perforation repair without the use of mucosal flaps•Trilayer interposition graft with temporalis fascia and a polydioxanone plate•Technically simple, highly successful perforation closure and symptom resolution