Computed tomography for constructing custom nasal septal buttons.
OBJECTIVE
To determine the efficacy of computed tomography in creating custom nasal septal buttons.


METHODS
Retrospective chart review and telephone follow-up.


METHODS
Tertiary care referral center.


METHODS
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).


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


METHODS
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%).


CONCLUSIONS
Custom septal buttons created using computed tomography are effective in relieving symptoms from large septal perforations.
Price
Daniel L
DL
Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minn, USA.
Sherris
David A
DA
Kern
Eugene B
EB
D006801:Humans; D009300:Nasal Septum / Q000293:injuries*; D019736:Prostheses and Implants; D014057:Tomography, X-Ray Computed