Acellular Human Dermal Allograft as a Graft for Nasal Septal Perforation Reconstruction

Objective: Nasal septal perforations pose a troubling source of morbidity for patients and a difficult problem for the Otolaryngologist. Multiple surgical techniques have been tried with inconsistent success. Prosthetic nasal buttons also have limitations, including patient intolerance and dissatisfaction. Acellular human dermal allograft, AlloDerm™ (LifeCell Branchburg, NJ) has been previously described as an alternative material for septal perforation repair. We aim to demonstrate objective and subjective outcomes, including quantification of patient's symptoms in septal perforation repair with AlloDerm. Methods: A prospective cohort study of twelve patients with 1-2cm anterior septal perforations that were recruited from a tertiary care practice. Patients with admitted smoking or cocaine use in the previous three months, vascular or granulomatous diseases were excluded. Subjective SNOT-22 scores along with objective nasal endoscopy and acoustic rhinometry measures were collected at baseline and 2, 4, and 12 weeks postoperatively, patients were followed for re-perforation 9-20 months post operatively. Data was normalized to baseline values and analyzed using ANOVA and Bonferroni correction. Results: Successful closure of the septal perforation was obtained in 10/12 patients and confirmed with rigid nasal endoscopy. Nasal symptom scores (SNOT-22) were significantly reduced to 52.8% (95%CI[35.1%-70.5.%];p