Septal perforations--prosthetic and surgical treatment

Septal perforations 4 mm or less in diameter have been successfully closed in eight out of ten patients with interposition of fascia temporalis. Larger perforations could, however, not be closed with this technique. Silicone buttons were helpful in half of the patients with perforations 5-20 mm. In larger ones they were not tolerated. With the vestibuloconchal flap technique perforations 7-20 mm were closed or markedly improved in four out of eight cases. Our conclusion is that small septal perforations should primarily be operated upon, whereas larger ones should initially be treated with silicone buttons. If uncomfortable, surgery may be successful. A preferred technique for larger perforations, however, cannot be recommended.