Medium to large septal perforations are a challenging problem to the rhinoplasty surgeon. In this study, records and outcomes are reviewed for 25 patients who underwent septal perforation repair over a 10-year period. All patients underwent an open septorhinoplasty approach with use of bilateral opposing mucoperichondrial flaps and a unique intervening graft that included acellular dermis, temporalis fascia alone, or a novel closure technique using temporalis fascia and a polydioxanone plate. The authors identify that for medium to large septal perforations, the use of the polydioxanone plate with temporalis fascia provided the highest rate of closure as a method of scaffolding a fascial graft, and also provided ease of placement between opposing mucoperichondrial flaps.
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