Long-term results of dermal grafting for the repair of nasal septal perforations.

The closure of nasal septal perforations is a significant surgical challenge with a high failure rate. Dermis placed between mucoperichondrial advancement flaps may be an alternative. The usefulness of dermal grafting for the repair of nasal septal perforations was initially investigated in an animal model. Four pigs had 1.5 x 2.5 cm perforations surgically created and closed with either temporalis fascia or dermis placed under a local mucoperichondrial flap. The dermal graft group had an average closure of 80% with histologically normal mucosal surfaces. The temporalis fascia group had no closure. Fourteen patients with chronic nasal septal perforations from iatrogenic causes, trauma, and drug abuse were repaired with dermal grafting. Nine patients had complete closure, 3 patients had partial closures, and 1 patient's graft dislodged on the first postoperative day. Dermal grafts placed between mucoperichondrial flaps are a viable alternative for the closure of nasal septal perforations.