[The custom made septal button].

Septal defects only warrant therapy when symptomatic. If surgical closure is not requested, the defect may be closed by a septal button. Prefabricated buttons are not an option for all sizes of defects. Moreover, they may even increase the size of the perforation. The problem can be elegantly solved by a custom made septal button, which minimizes the button's movements within the defect. With the aid of an intranasal cast, a silicone button is individually fabricated. From 1997 through 2004, 57 patients aged 19-85 years were treated by a custom made septal button. At the time of follow-up, 75% of patients still had the button in situ, and they were most satisfied with subjective all over improvement by 83% (+/-20%) on a visual analogue scale. Main symptoms improved significantly (p<0.05). Even though not all patients can be satisfactorily treated, we believe the custom made septal button to be an alternative if there are contraindications to surgery or in case of patient refusal.