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Comment & Response
Jul/Aug 2013

Importance of Mucosal Closure in Nasal Septal Perforation Repair

Author Affiliations
  • 1Division of Facial Plastic Surgery, Department of Otorhinolaryngology–Head and Neck Surgery, The University of Texas Health Science Center at Houston, Houston
  • 2Facial Plastic Surgery Associates, Houston
JAMA Facial Plast Surg. 2013;15(4):322-323. doi:10.1001/jamafacial.2013.1504

Cho et al1 present a novel method for repairing nasal septal perforations that they claim is easy, cost-effective, and associated with low patient morbidity. The technique involves the endonasal insertion of a polyethylene orbital implant that spans the perforation in the submucoperichondrial plane. The septal flaps are advanced as much as possible, and an inferior turbinate mucosal graft (presumably a free graft) is used in larger perforations. The technique completely relies on epithelial migration to slowly resurface the implant with mucosa. While the authors have had some success in a small series of patients, it seems to create a significant burden on the patient with regard to postoperative nasal care.

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