Clinical and histological results of septoplasty with a resorbable implant

Background: The use of a resorbable implant connected with septal cartilage would facilitate external septoplasty, offering mechanical stability until the cartilage fragments heal. Objective: To study the histological and clinical results of septoplasty wi th a resorbable implant (polydioxanone [PDS; Ethicon, Norderstedt, Germany] ) in conjunction with cartilage. Design: To provide histological information in 5 rabbits, PDS foil was impl anted into the outer ear in conjunction with an artificial cartilage defect . Observations were made at 2, 5, 10, 15, and 25 weeks. Resorption of the i mplant was investigated, including the time to complete elimination. In add ition, septoplasty with PDS foil was performed on 71 patients with severe s eptal deformities. Surgery consisted of excision of the quadrilateral carti lage and division into straight fragments, which were sutured to the PDS fo il and replaced as a free graft. Setting: Ear, nose, and throat department of the General District Hospital Steyr, Steyr, Austria: Results: Histological examination showed that the foil remained unchanged f or at least 10 weeks and was completely resorbed after 25 weeks with minima l remaining scar tissue. Newly formed cartilage developed bordering the car tilage defect. In the clinical study, all patients experienced varying degr ees of improvement in nasal blockage. No immediate or long-term complicatio ns occurred. Conclusions: The use of PDS foil in connection with cartilage facilitates s urgical correction of severe septal deformities, additionally providing sup port for the nasal dorsum. The histological examination showed that no infl ammatory or foreign body reaction occurred. Cartilage regeneration was even found. The foil was completely resorbed within 25 weeks, avoiding the long -term complications that occur with other artificial implants.