Background: Nasal septal perforation (NSP) represents a challenging clinical condition with significant functional impact and heterogeneous presentation. Surgical repair remains the treatment of choice for symptomatic moderate and large perforations, yet optimal techniques are still debated.
Objective: To evaluate the effectiveness of the sandwich graft technique using polydioxanone (PDS) plates combined with cartilage graft and platelet‑rich fibrin (PRF) membranes in the surgical treatment of moderate nasal septal perforations.
Materials and Methods: A prospective study was conducted on 22 patients with moderate NSPs (1‑2 cm), treated between April 2022 and December 2025. The surgical technique consisted of bilateral PDS plates with interposed cartilage graft and PRF membranes. Patients were followed endoscopically at 1, 3, 6, and 12 months postoperatively.
Results: Complete closure of the perforation was achieved in 77% of cases at the first postoperative evaluation, increasing to 91% at 6 and 12 months. Partial closure persisted in 9% of patients, all of whom were smokers. No major complications were reported.
Conclusions: The sandwich graft technique using PDS plates and PRF membranes is a safe, effective, and reproducible method for repairing moderate nasal septal perforations, offering high success rates and favorable functional outcomes.
