Original Investigation |

Polyethylene Implants in Nasal Septal Restoration

John J. W. Cho, MD1; Regan C. Taylor, MD, MSc2; Michael W. Deutschmann, MD1; Shamir P. Chandarana, MD, MSc1; Paul A. Marck, MD1
[+] Author Affiliations
1Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada
2Faculty of Medicine (Dr Taylor), University of Calgary, Calgary, Alberta, Canada
JAMA Facial Plast Surg. 2013;15(4):275-279. doi:10.1001/jamafacial.2013.840.
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Importance  Numerous techniques have been described to repair nasal septal perforations (SPs). However, many are technically challenging, with varying degrees of success.

Objective  To evaluate the use of polyethylene (Medpor; Porex Technologies) implants in the closure of nasal SPs.

Design and Setting  Prospective cohort study in an academic research setting.

Participants  Fourteen patients with a nasal SP were identified between March 1, 2008, and February 1, 2011.

Intervention  Each patient underwent repair of the nasal SP with a polyethylene orbital sheet implant. After measuring the size of the SP, the implant was trimmed and shaped to fit appropriately. The implant was then placed between bilateral mucoperichondrial flaps using an endonasal approach.

Main Outcome and Measure  Successful closure of the nasal SP with an intact polyethylene graft and complete remucosalization by the 1-year follow-up visit.

Results  The most common initial symptoms of SPs were nasal obstruction, crusting, and epistaxis. The SPs ranged from 0.5 to 4.0 cm in diameter. Thirteen of 14 patients (93%) who underwent repair of their nasal SPs with a polyethylene implant had successful closure.

Conclusion and Relevance  The use of polyethylene implants is effective and technically easy and is associated with low patient morbidity because it does not require the harvesting of tissue from other donor sites.

Level of Evidence  4.

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Figure 1.
Preoperative View

Preoperative view of an anterior nasal septal perforation.

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Figure 2.
Postoperative View

Postoperative view of a closed nasal septal perforation using a polyethylene (Medpor; Porex Technologies) implant.

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