Numerous techniques have been described for nasal septal perforation repair, with various degrees of success in achieving closure. Evidence supports the use of bilateral mucoperichondrial advancement flaps with interpositional grafting for greatest success. Many surgeons use autografts such as fascia, cartilage, bone, and pericranium, however, extracellular matrices have also become popular.
We analyze factors determining the success of nasal septal perforations repaired using using an acellular, freeze-dried interpositional xenograft derived from Porcine Small Intestinal Submucosa (PSIS).
Patients with septal perforation repaired by the senior author from 1998 to 2006 were examined in a retrospective chart review with regard to perforation size, etiology, pre- and postoperative symptoms, follow-up, outcomes and complications.
Forty-seven PSIS repairs were performed on 46 patients. Two procedures were planned staged procedures. Of the total 47 procedures, 41 (87.2%) continued to be closed at the site of repair during the follow up period. Follow up ranged from 6 months to 4.9 years with a mean of 18.3 months. Two patients (4.3%) were found to have perforations at the site of closure in the immediate post-operative period. One patient (2.1%) perforated at the site of closure after the immediate post-operative period. Subjective symptom scores demonstrated improvement in crusting, epistaxis and obstruction postoperatively. Larger perforations correlated with poorer outcomes.
The authors conclude that closure of nasal septal perforation with an interpositional xenograft derived from PSIS compares favorably to published results for autografts with advantages including absence of donor site morbidity, easy graft modification and manipulation, and shorter operative time.
Recommended CitationGreywoode, MD, Jewel; Hamilton, MD, James; Malhotra, MD, Prashant S.; Saad, MD, Abdel; and Pribitkin, MD, Edmund A., "Repair of Nasal Septal Perforation with Porcine Small Intestinal Submucosa Xenograft" (2012). Department of Otolaryngology - Head and Neck Surgery Faculty Papers. Paper 23.