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Septal Perforation Repair Using a Temporoparietal Fascia and Polydioxanone Plate Construct: A Multi-Institutional

Seth J Davis1, Monica Rossi Meyer2, Emily Misch3

  • 1Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Facial Plastic Surgery & Aesthetic Medicine
|September 29, 2022
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Summary

Temporoparietal fascia (TPF)-polydioxanone (PDS) plate interposition grafting effectively closes nasal septal perforations (NSPs) in 95% of patients. This surgical technique significantly improves symptoms and quality of life, regardless of institutional setting.

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Area of Science:

  • Otolaryngology
  • Plastic Surgery
  • Surgical Innovation

Background:

  • Nasal septal perforations (NSPs) present significant surgical challenges.
  • Existing closure techniques may paradoxically worsen symptoms.
  • Temporoparietal fascia (TPF)-polydioxanone (PDS) plate interposition grafting is an advanced repair method.

Purpose of the Study:

  • To evaluate the efficacy of TPF-PDS interposition grafting for NSP closure.
  • To compare outcomes across diverse institutions and patient factors.
  • To assess symptom improvement and complication rates.

Main Methods:

  • Retrospective review of 62 patients across seven U.S. institutions over five years.
  • Analysis of NSP closure rates, symptom improvement, and Nasal Obstruction Symptomatic Evaluation (NOSE) scores.
  • Evaluation of postoperative complications, including residual crusting.

Main Results:

  • Successful NSP closure and symptomatic improvement in 95% of patients.
  • Average reduction of 42 points in postoperative NOSE scores.
  • Residual crusting observed in 29% of patients, unrelated to external factors.

Conclusions:

  • TPF-PDS interposition grafting demonstrates high effectiveness for NSP repair.
  • The technique is successful across varied clinical settings and patient populations.
  • NOSE score improvements correlate strongly with patient-reported outcomes.