PRP and Diced Cartilage-Enhanced Fascia Lata: A Composite Graft for Septal Perforation Repair

Abstract

Objective: Nasal septal perforation (NSP) is characterized by defects in the mucosal, cartilaginous, and bony structures of the septum, most commonly resulting from septoplasty. Spontaneous healing of NSPs is rare, necessitating surgical intervention once the condition stabilizes. Numerous techniques have been developed for NSP repair. This study presents a novel technique combining fascia lata grafts, platelet-rich plasma (PRP), and diced septal cartilage harvested from the patient's remaining deviated nasal septum for the repair of medium-sized NSPs.Methods: A retrospective analysis was conducted on 32 patients who underwent NSP repair between July 2022 and July 2023. The repair utilized fascia lata, PRP derived from venous blood, and diced cartilage from residual septal cartilage. The procedure involved an open rhinoplasty approach for graft placement, followed by stabilization using endoscopic techniques.Results: The mean horizontal and vertical diameters of the septal perforations were 12.06 +/- 2.87 mm and 13.12 +/- 2.44 mm, respectively. All patients had medium-sized perforations (0.5-2 cm). The mean follow-up period was 12.03 +/- 1.11 months. Complete closure was achieved in 28 of 32 cases (87.5%). The cohort included 18 males (56.3%) and 14 females (43.8%), with a mean age of 35.47 +/- 5.31 years (range: 25-45). Ten patients (31.3%) were smokers, among whom 4 experienced incomplete closure. Smoking was not significantly associated with repair failure (P = .06).Conclusion: This novel technique combining fascia lata, PRP, and diced septal cartilage offers a reliable and effective approach for the repair of medium-sized NSPs.