fig5

Figure 5. The Trilayer TPF Graft. The trilayer TPF graft is constructed from autologous TPF wrapped around a PDS plate, taking care to ensure that all edges of the plate are completely covered with fascia (A-C). The interposition graft is then placed between the two mucoperichondrial flaps in the area of the septal perforation with the graft size exceeding the size of the defect in both anteroposterior and vertical dimensions (D and E). Reprinted with permission from Hadford et al. American Journal of Otolaryngology. 2023;44:103883, with permission from Elsevier^[31]. TPF: Trilayer temporalis fascia; PDS: polydioxanone.