Novel Technique for Nasal Septal Button Insertion: The Sutured Rosette
Nasoseptal perforation (NSP) is described as a defect through the cartilaginous nasal septum, which can be caused by various factors including iatrogenic (ie excessive nasal cautery), cocaine abuse, trauma and neoplasms (ie T cell lymphoma). Other associated aetiologies include severe septal deviation, rheumatologic conditions, allergy and vasomotor rhinitis. The presence of NSP increases airflow velocity in the nostrils and can lead to whistling noises, crusting, discharge, epistaxis and nasal tip or valve collapse. Surgical repair of NSP in the form of reconstruction is one option; however, success can be limited to two‐thirds of paediatric patients. A common surgical repair option is the placement of prosthetics such as obturators and septal buttons, which can close the perforation mechanically without further disrupting the damaged tissue. These prosthetics can be made of several different materials including silicone elastomer, acrylic, luxene plastic and nylon. Pre‐made septal buttons have been shown to decrease operating time but downsides include a poor fit, difficult insertion, nasal obstruction, irritation, crusting, infection and perforation enlargement. Although many techniques have been described, we introduce a novel technique called the “sutured rosette,” which is not only easy to perform but also effective. We highlight the use of this novel technique in our paediatric population.
Cohn, Jason E.; Soni, Resha S.; Chemakin, Katherine; and Terk, Alyssa R., "Novel Technique for Nasal Septal Button Insertion: The Sutured Rosette" (2019). Otolaryngology (ENT) Resident Research. 34.