This video demonstrates the repair of a large nasoseptal perforation via an open approach with a combined temporalis fascia graft and polydioxanone (PDS) plate technique.
Repair of a large >2cm nasal septal perforation via an open approach using a combined temporalis fascia graft and polydioxanone (PDS) plate technique
Symptomatic nasal septal perforation. Revision repair of nasal septal perforation,
Active intranasal drug use. Untreated destructive autoimmune condition with sinonasal manifestations
Position: Supine. Slight reverse-trendelenburg. Zero degree operating endoscope.
One must obtain a full history including current and past drug use, signs and symptoms of autoimmune disease, history of prior nasal/sinus surgery. Complete physical exam including nasal endoscopy and measurements of the dimensions of the septal perforation.
Septum, temporal region
Positive - provides excellent exposure and robust graft material to repair the septal perforation. Negative -inverted V transcollumellar incision scar; patient must remain with septal splints in place for at least 4 weeks
Septal hematoma, persistent perforation, bleeding, pain, nasal crusting, nasal obstruction, infection