Are polydioxanone plates combined with temporoparietal fascia the best technique for repair of nasal septal perforation?

Background: The repair of nasal septal perforations is challenging. Interposition of polydioxanone (PDS) plates combined with fascia graft have been described in the literature with high success rates.

Aims: This study aims to present a case series on the closure of nasal septal perforation using this technique and to evaluate its outcomes.

Material and methods: Retrospective evaluation of patients who underwent surgical repair of nasal septal perforations with interposition fascia graft and PDS plates from 2020 to 2023.

Results: Nine patients were evaluated, 66.7% were male and the mean age was 40.7 years. The perforation size ranged from 0.9 to 4.5 cm (largest diameter). All procedures were performed by an open approach and all patients received interposition grafts of PDS plates - eight cases combined with a temporoparietal fascia graft and one combined with a rectus abdominis muscle fascia graft. Eight patients (88.9%) achieved complete closure of the perforation. No other complications were reported.

Conclusions and significance: Interposition temporoparietal fascia graft combined with PDS plates could be a highly effective technique, demonstrating good functional and anatomic outcomes with low morbidity at the donor site. This composite can be applied to small and large perforations as surgical success does not appear to be affected by the defect size.