The nasal septum is the partition between your left and right nostrils and it travels up the nasal passages. The front is composed of cartilage and the back of the bone. A perforated nasal septum indicates that there is a hole in the septum. It creates a channel that allows air to flow from your left to right nasal cavity. Symptoms of a hole in the septum may or may not include nosebleeds, difficulty breathing, and a stuffy nose.
As you exhale, you may generate a whistling sound. You may also suffer from crusting. In almost half of cases, this develops after previous nasal surgery. Additional reasons include:
- Treatment for nosebleeds with cautery
- Diseases including lupus, cancer, syphilis, and tuberculosis
- Problems with your nose, such as a broken nose or a nose that has been picked at too much
- Infections
- Overuse nasally administered medicines, such as prescription, over-the-counter nasal sprays, or even cocaine.
A hole in the septum can be repaired surgically in certain cases, however, this is not always the case and surgery is not always necessary. The larger the hole, the more work it will take to repair it.
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What Is A Nasal Septum?
Your nasal airways—left and right—are separated by a wall called the nasal septum. The nasal septum is covered on both sides by a thin layer of soft tissue, and it is formed of cartilage and thin bone. If you pinch the tip of your nose, you’ll feel the nasal septum in the middle.
When the nasal septum is perforated, it allows air to leak out of the nose. Whatever the reason for the perforation, the hole’s size might vary. The following details the indications for a nasal septal perforation repair and the methods used to bring about that outcome.
Is It Possible For A Septal Perforation To Heal On Its Own?
The hole will never heal on its own. Due to the fragile nature of the tissue, a successful repair of a perforated nasal septum is challenging.
What Expertise Makes Someone A Nasal Septal Perforation Repair Specialist?
Septal perforations require the expertise of specialized surgeons in order to be effectively treated. Otolaryngologists (also known as ENT surgeons) typically have the training to repair such holes in the nasal septum. Specialists, such as Facial Plastic Surgeons, may be needed to fix larger and more intricate holes. Make sure you trust the doctor who performs the nasal septal perforation repair wherever you go. Your surgeon should also perform a large number of repairs per year.
How Are Nasal Septal Perforations Treated?
Care for septal perforations aims to alleviate the distressing symptoms brought on by dry nasal passages. To avoid nasal crusting, bleeding, scabbing, and airway obstruction, treatment focuses on increasing the humidification of exhaled air. Lubricating ointment and antibiotic ointment are two examples of nasal ointments used to prevent tissue dryness. Even when you’re sleeping, nighttime dryness might be a problem. For this reason, a humidifier placed next to the bed is a common recommendation.
As an added benefit, nasal saline irrigation can be used to remove crusting, stop the formation of scabs, and keep the nasal passages moist. You should absolutely avoid picking the nose. Despite this, such treatments have their limits because they aim to alleviate symptoms rather than fix the hole itself. Surgical alternatives exist for patients with perforations that cause ongoing discomfort.
Preparation For A Septal Perforation Repair
When symptoms from a perforation, such as bleeding, crusting, blockage whistling, or nasal collapse, become too much to bear, surgery should be considered. Maintaining enough blood flow in the postoperative phase is crucial to the effectiveness of repairs. Patients are strongly advised to abstain from smoking for a minimum of 6 weeks before surgery and 6 weeks following recovery. Patients may also need to stop using any supplements or over-the-counter drugs that are hindering the healing process.
How Do You Repair A Septal Perforation?
Surgical treatments for repairing a hole in the nose range in complexity and specificity depending on the perforation’s size and location:
1. Septal Button
The hole is closed by a prosthesis, which is inserted into the body. There is the potential for discomfort during such treatment due to the insertion of a foreign object into the nasal cavity. Infections might develop, necessitating regular medical visits to get replacements. Both physicians and patients no longer see any benefit in using them.
2. Local Tissue Flap
It is possible to utilize local flaps to mend perforations less than 2.5 cm in diameter. When a hole occurs, the surrounding tissue is used to patch it up. In most cases, this method necessitates same-day surgery at an outpatient surgical facility. As your body heals after surgery, you could feel some pain. The likelihood of a local flap being successful reduces with increasing hole size. Since no foreign material is inserted into the nose (like a septal button), individuals experience fewer symptoms after this sort of surgery.
3. Free Tissue Transfer
This method involves transferring free tissue from under the skin to the side of the head or the side of the leg to help the hole heal. The tissue is placed inside the hole so the cells inside the nose can grow over the tissue to heal the hole. This process also involves placing dressings in the nose for around a month which are then removed.
