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Septal perforations 4 mm or less in diameter have been successfully closed in eight out
of ten patients with interposition of fascia temporalis. Larger perforations could,
however, not he closed with this technique.
Silicone buttons were helpful in half of the patients with perforations 5-20 mm. In
larger ones they were not tolerated.
With the vestibuloconchal flap technique perforations 7-20 mm were closed or
markedly improved in four out of eight cases.
Our conclusion is that small septal perforations should primarily be operated upon,
whereas larger ones should initially be treated with silicone buttons. If uncomfortable,
surgery may be successful. A preferred technique fo'r larger perforations, however,
cannot be recommended.