Trilayer Temporalis Fascia Interposition Graft for Nasal Septal Perforation Repair: A Continued Experience.

Abstract

Objective: The repair of nasal septal perforation (NSP) is complex, with a variety of described techniques and reported outcomes. At our institution, we commonly perform NSP repair using a trilayer graft of thin polydioxanone (PDS) plate wrapped on both sides with temporalis fascia without intranasal flaps. We aim to report our continued experience with this technique.

Study design: Retrospective chart review.

Setting: Single institution.

Methods: Retrospective chart review of patients undergoing repair of NSP using a trilayer temporalis fascial interposition grafting technique at our institution from 9/1/2018 to 10/31/2023.

Results: Fifty-six patients (mean age 45 years, 58.9% female) were included in this study. The suspected cause of NSP was primarily iatrogenic (n = 26, 45.6%); however, a large number of patients did not have a definitive etiology of NSP (n = 18, 32.1%). The most commonly reported symptoms pre-operatively included nasal obstruction/congestion (n = 51, 91.1%) and nasal crusting (n = 31, 55.4%). NSPs were most frequently anterior in location (n = 46, 82.1%) and medium in size (1-2 cm) (n = 31, 55.4%), followed by small (<1 cm) (n = 17, 30.4%). All patients within this study experienced improvement in their pre-existing symptoms associated with NSP, with complete resolution of prior symptoms occurring in the majority of patients (n = 44, 78.6%). A minority of patients in this cohort experienced postoperative complications (n = 8, 14.3%). One patient (1.8%) demonstrated persistent perforation following repair. The median length of follow-up in this study was 257 days (range 65-1724).

Conclusion: The trilayer temporalis fascial interposition graft is an effective and reliable tool for the repair of NSP.