Symptom Outcomes After Septal Perforation Surgical Repair Versus 3D-Printed Customized Prosthesis.

Abstract

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). 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. 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). 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.