Trilayer temporalis fascia interposition graft: A reliable technique for nasal septal perforation repair

Purpose: Nasal septal perforation (NSP) repair is a complex procedure with variable techniques and success rates. In this study we describe NSP repair using a trilayer interposition graft of temporalis fascia and thin poly-dioxanone (PDS) plate without intranasal flaps and report outcomes in our patient population.Materials and methods: IRB-approved retrospective review of 20 consecutive patients presenting to a tertiary medical center with NSP from September 2018 to December 2020 and who underwent NSP repair via our trilayer temporalis fascia interposition graft. De-identified patient data was obtained from the medical record and stored on an encrypted secure server. Descriptive statistics were examined for each variable.Results: All 20 NSP repairs demonstrated durable repair with complete mucosal coverage at last follow-up (average 7 months). Complete resolution of preoperative symptoms was achieved in 85 % of patients, with partial resolution in the remaining 15 %. Of the 20 perforations 25 % were small (<1 cm), 50 % medium (1-2 cm), and 25 % large (>2 cm). The only surgical complication was a single intranasal synechiae. No graft harvest site complications were noted.Conclusion: The application of a trilayer temporalis fascia -PDS plate interposition graft without intranasal flaps is highly effective for repair of NSP.