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eptal perforation (SP) is a common nasal disorder. A 2003 Swedish study 1 quoted a 0.9% prevalence of SP among the general population. The origin of SP is associated with the following 4 main causes: trauma, iatrogenesis, inflammation or malignancy, and inhalation. 2 Once the mucoperichondrium of the nasal septum becomes traumatized, diminished blood supply can lead to cartilaginous and mucosal necrosis. 3 Local reepithelialization of the mucosal edges then occurs, preventing closure of the defect. 4 Patients with SP may be seen with various symptoms and signs that often correspond to the size and location of the SP. An asymptomatic SP does not require any intervention. 5 Most symptomatic SPs are large and anterior, while posterior SPs tend to be less symptomatic due to humidification of the passing air by nasal mucosa and turbinates. 3 Common symptoms include nasal crusting, discharge, epistaxis, parosmia, neu-ralgia, and a whistling sound with inspiration. Some patients may manifest low-grade perichondritis, requiring long-term antibiotic therapy. Larger long-standing SPs can also cause atrophic rhinitis and saddle nose from a lack of nasal dorsal support. 2,6,7 Despite their being a common problem, SPs have been a distinctive challenge for otolaryngologists and facial plastic surgeons. Various techniques have been described to close SPs, and no single technique is recognized as being uniformly reliable in applying to all cases. 2 Furthermore, SP repair is often performed in noses that have already undergone surgery and have limited tissue and a compromised blood supply for reconstruction. Therefore, most SPs remain unclosed because available techniques are technically difficult and require extensive training and experience to master. IMPORTANCE Numerous techniques have been described to repair nasal septal perforations (SPs). However, many are technically challenging, with varying degrees of success. OBJECTIVE To evaluate the use of polyethylene (Medpor; Porex Technologies) implants in the closure of nasal SPs. DESIGN AND SETTING Prospective cohort study in an academic research setting.

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