Journal archive · Septum, valve and airway · Outcomes, satisfaction and psychology · Complications and management · Anatomy and nasal analysis · 2026
Symptom Outcomes After Septal Perforation Surgical Repair Versus 3D-Printed Customized Prosthesis
Gomes PL, Kumar N, Bansberg SF, Marino MJ, Lal D, Miglani A.
In the archive as a landmark paper: the core sweep runs 2011–2026, and this one is here because the history of rhinoplasty rests on it · cited on septal perforation.
Abstract
Objective: Surgical repair and 3D-printed customized septal prosthesis (3D-PCSP) are options for septal perforation treatment. We performed a study to compare the clinical outcomes of surgery and 3D-PCSP using the NOSE-Perf Scale (NPfS).
Methods: A chart review was performed on patients undergoing surgical repair or 3D-PCSP placement between January 2018 and July 2024. The change in NPfS was used as primary endpoint. Demographics, ASA score, perforation size, etiology, and follow-up duration were reported.
Results: Thirty-five patients, 23 for surgical repairs and 12 for 3D-PCSP, were included in this review [median (IQR)]. In the surgical repair group, perforation length and height measured 12 (10-18) mm and 10 (8-15) mm, respectively. Baseline NPfS was 24 (16-32), and this decreased to 8 (6-13) following surgical repair (p < 0.001). Follow-up time was 12 (5-21) months. In the 3D-PCSP group, septal perforation length and height measured 25 (15-30) mm and 17 (15-20) mm, respectively. The baseline NPfS was 17 (3-24.5), and this decreased to 9.5 (7-13) following 3D-PCSP placement (p = 0.001). The follow-up was 18.4 (16-23) months. NPfS reduction was greater for surgical repair (p = 0.018).
Conclusions: Surgery and 3D-PCSP offer meaningful symptom relief for NSP patients. Treatment decisions should be individualized through shared decision-making that considers patient comorbidities, preferences, surgeon experience, and risk tolerance. In this cohort, surgical repair was associated with greater NPfS reduction compared with 3D-PCSP placement.
Abstract as indexed by PubMed; the article is open access (PubMed Central).
Citation
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What the rhinoplasty literature says on this paper's topics, cited line by line to PubMed.
Septum, valve and airway
Every rhinoplasty is a breathing operation whether it intends to be or not: the septum holds the nose up as well as dividing it, and the narrowest part of the whole airway is the internal valve the surgeon is standing over.
Outcomes, satisfaction and psychology
Rhinoplasty is measured with ten different questionnaires, none of which covers both the way the nose looks and the way it breathes, and the best-developed one has no airway questions at all.
Complications and management
Serious complications after rhinoplasty are rare: infection runs under 1% in the two largest single-surgeon series, pooled rib harvests record no pneumothorax, and the bleeding series record no thromboembolism.
Anatomy and nasal analysis
Before any technique is chosen, the nose has to be read: the bone measured, the cartilage counted, the skin assessed, and the result the patient wants agreed on a photograph that is not yet true.
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