Polyethylene implants in nasal septal restoration

JAMA Facial Plast Surg. 2013 Jul-Aug;15(4):275-9. doi: 10.1001/jamafacial.2013.840.

Abstract

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.

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Endoscopy / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Nasal Septal Perforation / surgery*
  • Plastic Surgery Procedures / methods*
  • Polyethylene
  • Polyethylenes*
  • Prospective Studies
  • Prostheses and Implants
  • Prosthesis Design
  • Prosthesis Failure
  • Prosthesis Implantation / methods*
  • Treatment Outcome

Substances

  • Medpor
  • Polyethylenes
  • Polyethylene