This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on ISI (2)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Facial Plastic Surgery  • Nasal Surgery  • Computed Tomography  • General Rhinology  • Radiology of Head & Neck  • Alert me on articles by topic

Daniel L. Price, MD; David A. Sherris, MD; Eugene B. Kern, MD

Arch Otolaryngol Head Neck Surg. 2003;129:1236-1239.

Objective  To determine the efficacy of computed tomography in creating custom nasal septal buttons.

Design  Retrospective chart review and telephone follow-up.

Setting  Tertiary care referral center.

Subjects  Ninety-five patients with symptomatic septal perforations repaired with custom Silastic septal buttons fashioned from reformatted computed tomographic images. Follow-up greater than 1 month was obtained in 74 patients (range, 1 month to 17 years; mean, 44.6 months).

Interventions  Custom septal buttons were placed intranasally under local or general anesthesia.

Main Outcome Measures  Patients were evaluated for resolution of preoperative symptoms related to the septal perforation, new symptoms related to the button, and duration of button retention.

Results  The average perforation was 2.6 cm in diameter (range, 6 mm to 6.0 cm). Nine buttons (12%) came out unexpectedly. Nine buttons were removed because of patient intolerance, and 14 buttons were lost or removed after 5 years, longer than the projected button life span. Excluding buttons that were removed because of patient intolerance, 56 (86%) of 65 buttons were in place for longer than 5 years or at the most recent follow-up. Most patients experienced improved breathing (60%) and a considerable reduction in epistaxis (77%) and nasal crusting (59%).

Conclusion  Custom septal buttons created using computed tomography are effective in relieving symptoms from large septal perforations.

From the Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minn (Dr Price), and Department of Otorhinolaryngology, SUNY-Buffalo, Buffalo, NY (Drs Sherris and Kern). The authors have no relevant financial interest in this article.